Second Year: Transitions

Second year was one of those strange in-between years.  You have survived first year, but don’t know enough to be fully let loose into the clinic.  The good thing is, you know what to expect.  You come back from a summer off (likely the last on one until retirement), and know you are going to jump headfirst into coursework again.  You know that classes and studying will dominate your days, and you will again get to know the lecture hall as well as the back of your hand. 

Classes:

At my school, second year continues with organ-based modules.  A few weeks are spent learning about the main organ systems including the circulatory system, respiratory system, digestive tract, etc. Clinical opportunities continue to be available, as every other week you still spend a day with a new preceptor. 

The Boards:

The biggest difference between 1^st and 2^nd year is the dominating thought on students’ minds: Step 1.  To become a licensed MD, you have to pass four large, challenging exams: Step 1, Step 2 CS, Step 2 CK, and Step 3.  Step 1 is notoriously known as the hardest of the step exams.  The test has seven blocks of 60 minutes, each block containing 48 multiple-choice questions.  And, the questions are hard.  It is quite possibly the most important score for residency applications.  Being the first exam, you aren’t quite sure which study methods will or will not work for you.  The test covers everything from first and second year of medical school, including a lot of foundation concepts that are not covered in the other exams.  And, of all of the boards, it is the least clinical.

My experiences with Step 1:

- Planning a wedding while studying for boards was a better decision than I thought it would be

- You really can study for 10+ hours per day… everyday… for weeks… and survive

- You need some entertainment during the day to break up the monotony of studying.

- Fewer are better.  Every time another student would talk about a new great book found to study from, I would get the urge to go out and buy it.  After a few weeks of jumping between different books (and wasting quite a bit of money), I discovered it is better to choose one or two thorough sources and do practice questions

- Get some exercise.  Running everyday kept me sane

- Don’t forget to go shopping.  You will need snacks

- Leave some time for vacation at the end

Living with Medical School:

Of all of the years of medical school, I feel second year was the most eventful in my personal life.  It was an exciting year, full of changes and milestones!

- Tony and I bought our first home!  After the disaster of living in our apartment, it was a welcomed change to have a place of our own.  We loved making our little 2-bedroom house a home.  Tony and I enjoyed our adventures to estate sales as well as repainting and redecorating.  We also learned that surprises come with new homes as well.  We didn’t realize it when we bought the house, but the previous owners had a little dog that peed on the carpet in the living room… a lot.  The carpet was only 3 years old (the date was on it), and it had at least 100 stains covering just about every inch.  It was not fun ripping that up, but were overjoyed to see the wood floors underneath. After refinishing the floors, it changed the entire feel of the downstairs

- Tony and I joined the acapella group at our school, “Docapella,” even though neither of us is especially great or even good at singing.  I discovered I am definitely more of a backup singer than a soloist.  However, we made a lot of new friends.  Erik became such a good friend to Tony and I that he became the best man at our wedding later that year!

- We made new friends!  This year, we started spending more time with Matt, another medical student, and his super cool girlfriend (now fiance!!), Ashley.  The dinners, football/super bowl parties, school formals, and movie nights that followed created some of my favorite memories during medical school.

- Tony and I got married!  Growing up, I never was the girl who walked around in my mom’s wedding dress imagining the day I would walk down the aisle.  For me, it has always been more about finding that special person than preparing for a single day.  Deciding on our wedding date was more last minute than we had anticipated.  We only had 4 months to plan the entire event!  We decided on a small wedding with a large reception a week later.

We were shocked by how much enjoyment came from planning this event.  Tony surprised me and really got involved in every detail.  We reconnected with old friends, and were blown away by the generosity from friends and family.  The wedding shower, bachelorette/bachelor parties, and wedding day itself were incredible.  

(Photos by Nathan Lyman, www.tru-e-motion.com)

I will never forget looking down the aisle at my husband and seeing how emotional he became when he saw me.  Certainly an amazing time in our lives!

First Year: Survival

First year is like being an infant all over again.  You are tossed into a new environment with a set of instruments you have no idea how to use.  There is this whole new language of medical lingo you have to learn.  No matter how many times you practice saying those fancy words in front of the mirror, you still sound like a total idiot when you first try them out in public.   And, regardless of how much of a people-person you think you are, seeing your first patient somehow still ends up awkward.  First year is very much about survival, trying to make it through without forgetting why you went to medical school in the first place.  And, with the many hours dedicated to class work each day, it is pretty easy to say, “What was I thinking when I signed up for this?!”

White Coat Ceremony:

- This is the first time you really think, “I am going to be a doctor.” This is probably the pinnacle moment for most first-years.  Unfortunately, it comes at the beginning of the year. 

-Gathered with friends and family, you feel super important putting on your shiny new (short) coat for the first time.  However, within a few short days, reality sets in and you realize it is a LONG road between putting on a white coat and becoming a real doctor.

Orientation Week:

- With med school classes being pretty small, you really do get to know most of your classmates in just a few days.  Information does have a way of quickly getting around, even if it isn’t 100% accurate.  I remember a classmate sitting 2 rows behind me during orientation and exclaiming, “Did you know that there are these two students, Tony and Laura, who already got ENGAGED?!”  I guess she didn’t know we actually knew each other before med school… and had been engaged for a year.

- People really do remember first impressions. It can be alarming how much of orientation stays with you over time. 

-I must have heard 100x that week that “all of you were the top students at your colleges, but not everyone can be in the top at med school.  Most of you will be in the middle, and that is ok.” I remember thinking that week even if I didn’t say it out loud, “bah I know I can be at the top.”  Then real classes started. The middle didn’t look so bad after all.

Clinic:

- At my school, we each are assigned a clinic to work at once every other week during the first year.  This is the first opportunity to really work with a “preceptor” (a physician).  After many hours studying and going to class, clinic days helped to keep me in touch with the whole goal of medical school. 

-There is a huge difference between a 4^th and 1^st year med student.  Watching the 4^th years in the office, I was absolutely in awe.  I thought I would never get to that level.  Then I became a 4^th year.

- It is incredible how much patients can teach you.  You can spend hours studying medical conditions, but nothing matches the power of hearing a patient’s story.  I still remember learning about Paget’s Disease, Steven Johnson’s Syndrome, and Celiac Disease from some of my first patients. 

- You make lots of mistakes, but generally patients are pretty kind about pointing them out to you.  I remember the first time I used my otoscope (meant to be used to look in the EARS) it didn’t go so well. After nearly blinding and poking out the eye of my patient, she laughed and suggested I try “that other one there on the wall” --- the ophthalmoscope.

Class work:

-In the first year, most of your time is spent in the classroom. You spend so much time in one room that the smell of the lecture hall becomes engrained in your nostrils.  That memory is so strong, I still feel transported back to first year when I enter it again.

-Even though there isn’t any assigned seating, pretty much everyone sits in the same spot everyday.  It is humorous to see that when changing rooms between first and second year, people continued to still sit in the same general spots they established first year.

- You have to master speed-learning.  An entire semester's worth of material is crammed into 2 weeks.  There always is another test around the corner.  Until the end of the year, it really doesn’t let up.

-Books.  Lots of books. And notes.  And books (the picture on the right doesn't even touch the surface of the books that I have collected over the last 4 years).

- Bring snacks and coffee.  Lots of coffee.

Anatomy:

- This was by far the hardest but most interesting class I took during my first year.  Everything was completely new: it was the first time I had seen a dead body.  I really knew nothing about the human body other than “the leg bone is connected to the knee bone.” 

- I have so much respect for the people whom donate their bodies to medical schools.  It is a gift that has contributed tremendously to my education as a medical student

- On the first page of my anatomy dissector, it called the cadaver “the first patient.”  While true, I find it ironic my first patient already was dead.  Probably not a good precedent to set.  

- There is nothing worse than spending hours dissecting in search of a nerve, only to discover you already cut it about half an hour ago.

- It is NOT cool to wear your anatomy scrubs outside of the lab.  Not only are they the most unattractive color discovered by man (at least mine were), you really do smell worse than you think

- Don’t bring your anatomy books to the lab.  It is disgusting to see grease smears on pages while studying during dinner.

Outside of the classroom:

- One of greatest lessons I learned first year was the importance of having a life outside of medicine.  I realized that when you spend all of your time around other med students, you could easily get in the habit of always talking about medicine.  You have to keep things other than medicine in your life, and encourage friends to do the same.  Get some low-maintenance hobbies.  Watch some low-budget films.  Find some great restaurants.  I found I am much happier, and a better med student, when I find that balance.

- You need a place you can sleep.  Living in a ground-level apartment was a horrible decision.  The neighbor above us was awful, and I am pretty sure I could write a novel from the relationship problems I heard about through the ceiling at 3AM.  There was no greater relief than the nighttime silence that came when we moved into our house.

- Apartments offering only street parking in Buffalo, NY are a bad idea.

- You need a support system.  Family and friends kept me sane during this long road. 

- I never would have made it through without my husband.  For us, it was helpful that we both went through medical school together.  However, this is a situation other people may not feel so comfortable with.  For us, it just works.  We are always a team, helping each other along the way.  Decisions are made together, from careers to what to have for dinner.  We are each other’s greatest fans, and at the end of a hard day we can depend on one another.  Studying together, we always support one another and never make it about a competition.  

My Medical School Journey

I make a habit of not blogging about medical school.  So much of my time is already dedicated to becoming a doctor. Between long hospital/clinic hours and returning home to study, every waking hour can easily be eaten up by medicine.  It is nice to have a few moments spared from research articles and treatment modalities.  This blog, photography, raising a dog, spending time with Tony, laughing with family, visiting childhood friends: these are the ways I have retained my humanity while becoming a doctor.  They are the small corners of my life I resist letting medicine take over.  I have learned you can obtain outstanding board scores, ace every class, read endless numbers of books… and still be a horrible physician.  It is incredibly important to find balance in any field of medicine.

As an exception to my own rule, I will be blogging about med school over the next couple of weeks.  Graduation is right around the corner.  In 2 weeks, I will forever put away my short white coat.  In 3 months, I will put on a gleaming resident’s coat with the freshly printed letters: MD.  Again, I will be at the bottom of another food chain but with many more responsibilities (and longer days to match).  This week I will be giving up some of my blog to this journey.  There will be 4 posts: one for each rewarding and challenging year dedicated to becoming a doctor.  Look for them in the coming days!

Easter Celebrations!

Easter was the first real holiday that Tony and I spent together.  Over Easter dinner, Tony met my grandparents for the first time in 2005.  He settled so easily into conversations with all of the family members, as if he had been coming over for years.  That Easter, I also happened to be fostering and bottle-feeding 3 young puppies.  Watching that handsome man juggle three adorable puppies melted my heart.  I remember, by the end of the day, I got the feeling that I would never be bringing another boyfriend home to meet the parents.  No one else would ever fit in so perfectly with my family. 

As a holiday dedicated to new beginnings through the resurrection of Jesus Christ, it was fitting again to see this Easter as one of “firsts.”  It was the first Easter in my life spent outside of Albion, as we celebrated at my parent’s house in Ithaca.  Margie, Paul’s girlfriend, joined us for the first time and quickly won over the whole family.  And, our furbaby Butters enjoyed his introduction to Easter as well.  On the difficult side, it was the first holiday spent together since the loss of my Grandmom Lucy earlier this year.  This really would have been an Easter she would have enjoyed.

As always, Mom cooked the food to perfection and the decorations were gorgeous.  The large ham and excellent quiches kept people coming back for seconds and thirds.  

It was such a blessing to gather with family and friends, enjoying wine, watching movies, and sharing stories.   

Paul and Margie surprised the family Easter morning with some great treats and special cards.  And, somewhere in the excitement of Easter, “Cookies and Cream Bunny” lost his head.

Butters was also very satisfied with his new “muscle shirt.”  Jessica, Margie’s daughter, picked it out (we all missed you, Jess, but look forward to seeing you at graduation!!).  It looked great on the little guy, and he happily modeled it around the house!  

I know this coming year will certainly be filled with many more “firsts” when Tony and I make our big move to Texas.  But, we will continue to look forward to special moments like these when we can come home to family and friends.  

A little light on the Easter decorations

Between the distractions of medical school and enjoying March break, Easter kind of snuck up on Tony and I.  It really didn’t seem like we had eaten enough Friday fish fries.  Hadn’t it just been Ash Wednesday?  And, somehow we made it almost all the way through March without purchasing a single bag of candy (something that never happens)!  However, last week we got our act together and finally bought bags of our Easter favorites: Reese’s mini eggs and Starburst jellybeans.

With our move to San Antonio right around the corner, we have promised ourselves to stay away from buying holiday decorations.  Tony and I have been working through the difficult task of sorting through all of the odds and ends.  It is amazing what accumulates in just a few short years.  We have already taken 6 bags of holiday items to the Salvation Army. Most of these items were long forgotten in the deep corners of closets.  So, we saved some money and storage space by using items we already had around the house to get a little Easter cheer going.

Butters also offered to help us out with the spring-cleaning by eating all of the Easter candy.  Much to his disappointment… no chocolate (or jellybeans) for little doggies

Butters enjoys spring

When Butters first came home with us from the breeder, we were reluctant to give him too much free-reign of the backyard.  With all of the rain (instead of snow) that winter brought to Western NY, the yard turned into a giant mud pit.  Daily baths for a puppy got old really quickly!  He also felt the need to help us clean up all of the rabbit droppings that once covered the area.  Our yard used to be the only safe haven in the neighborhood for wild rabbits.  Luckily, Butters has made sure that no rabbit will ever step foot in our yard again!

Now that the yard has dried up a bit (and the droppings seemed to have disappeared), Butters has discovered that he really LOVES the backyard.  When I am trying to find him, there usually is a good chance that he will be watching for birds through the sliding door.

I love to watch him when he first heads out.  As soon as I open the door, he runs into the backyard like a wild-man!  

Recently, he has seemed to taken an interest in eating dandelions.  I swear, this dog really would eat anything!

And, of course, he sulks a little when he has to come back in...

... at least until he gets his treat :)

World's. Worst. Beggar.

Last weekend, Tony and I celebrated the end of March break with a surf-and-turf night.  This was something we had planned all week, and we had so much fun preparing this delicious meal as a couple.  The table was set and the wine was opened.  The lobster and steak were cooked to perfection.  We were all ready to sit down for a romantic dinner, just the two of us.

But then, there was this…

Worst. Beggar. EVER. This little dog has a lot of great qualities, but his bottomless appetite is not one of them.  And with TWO meat options that night, he was especially on his worst begging behavior.  We make a habit of not feeding Butters at the table, but he seemed to have forgotten all of his training that night.  He gave multiple attempts to convince us he was worthy of a few table scraps.  He tried sitting patiently…

When that didn’t work, he went to his crate hoping we would award him with just one… or two… or three samplings of lobster.

And when these attempts didn’t work, he really put on the charm…

Who doesn't want CRAZY puppy eyes staring over the table?!  

Needless to say, while Tony and I didn’t have the peaceful candle-lit dinner we had imagined, we got a good laugh out of Butters’ desperate attempts at sharing surf-and-turf night with us.

And, we topped it off with Tony's favorite dessert... Strawberry Shortcake!

But, sorry Butters.  Your treats come later.