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Epiphany

Friday, October 23, 2020

Done With Babies, Time For Grownups

SAK PASE!

Hey youuu, guess what!? I just finished my first rotation in medical school! I know it's only one rotation but I couldn't be more excited. So last time I posted, I told y'all that I completed two weeks of inpatient pediatrics and that I was starting outpatient pediatrics that following Monday. Welp now I'm done with 4 weeks of outpatient pediatrics. I took my pediatrics shelf exam yesterday and I just found out today that I passed. So grateful!! I'll delve into more details....

So, I did my outpatient Peds at a Pediatric clinic in Aventura. I live really close so it was great for me! So there are two Pediatricians who own the clinic and they are brothers. We also worked with two Nurse Practitioners, one more than the other. 

A typical day: I get there at 8:50am and we start at 9am. Some days we see sick patients in the morning and well visits in the afternoon. Other days, it's flipped so well visits in the morning, sick patients in afternoon. The clinic is realllllyy busy so you'll definitely have lots to do. So I would go into the patient's room after the MAs finish their vitals signs. But while the MAs are doing the vital signs, I go to the patient's chart just to review their past medical history, their discharge papers from the hospital if they were recently born and any previous notes and visits at the clinic. Just to get an idea of what kind of patient I'm dealing with and what to expect in terms of medical problems and what to ask for. Next, I go to the patient's room and get an H&P (history and physical). For sick visits, I only usually ask about the chief complaint and OLD CARTS (onset, location, duration, characteristics, associated/aggravating symptoms, relieving factors, timing and severity). But for Well Visits, I ask about ERRTHANG. If the patient is a baby, I ask about feedings, dirty diapers, wet diapers, sleep, meds, and all of the above. If an adolescent, we ask about school, exercise, drugs, smoking, alcohol and we screen for depression in addition to the rest. After the history, I do a physical exam. Then I go report to the physicians or to the nurse practitioners then we go into the room together. If I have questions, I ask the doctor or the NP afterwards. Sometime the physicians sit down and give us a lecture on a case they saw at their rounds in the hospital that morning or they do a lecture on a topic that we've asked them about. Sometimes they give us uptodate articles to read then we go over it together mostly after lunch. Okay so then we get lunch...sometimes an hour, sometimes 30 minutes. Then get back to the grind in the afternoon at 1:30pm and then we go home sometimes by 5:30pm sometimes 6:45pm lol, it really depends on the day.

Like I said, it was really fast paced so there wasn't any downtime. I actually ordered some compression stockings/socks on amazon because at the end of the day my feet were swollen and IN SO MUCH PAIN that I had to elevate them when I got home. Plus I run several times a week and that's usually a task because of how much my feet hurt. Since I bought the compression stockings, my feet hurt less at the end of the day. They hurt less but they still hurt lmbo! Overall, it was a great experience, I am still very much interested in pediatrics but we'll see after I complete all of my core rotations! 

I also mentioned that I took my pediatrics shelf yesterday. It was 110 questions and 2 hours and 45 minutes long. I found out today that I passed. Y'all I was scared shitless! lmaooo I finished that exam and I was scaaaared. I ran out of time and had to guess on the last few questions and there was a lot of randoms in there I didn't know and I was legit scared but to God be the Glory. He always comes through for your girl! 

How did I study for my shelf? I did all 400 and something pediatric questions on Uworld. I also did a good amount of Amboss questions in the beginning of the rotation. I think around 80 or so. I did the Zanki Peds deck on the Anki app. I took two NBME Practice exams. I watched all of the Online med ed videos. I watched Emma Holiday's peds review on youtube. I watched Divine intervention's Peds review on youtube, and finallly I watched Dr. High Yield's peds review on youtube. I think that's about it. I learned a lesson for next time...I should have ran through the uworld peds questions TWICE but I only had time to run through them once and that's because I started studying too late. 

It was a struggle for me to study. By the time I came home I was soooo tired. I had to run, shower, eat, study then go to bed on time. There wasn't nearly enough time in the day for all of that. But I did it!! If I could make it through this first rotation, I know I can make it through the rest! 

So now I'm done with the babies, now it's time for grownups! I start the outpatient part of my INTERNAL MEDICINE rotation on Monday! I'm doing 6 weeks of outpatient at a clinic near me! Again it's only like 15 min away from me. SO SO grateful! 

Alright that's all folks. Enjoy these pics below. I had to blur out a part of the second pic because of patient information lol. That pic is one of all of the students rotating at clinic. 

Like usual, email me if you have any questions. But it seems like y'all prefer messaging me on IG instead so feel free to do that too, whatever's clever!




TTYL 💜

Saturday, September 26, 2020

A Day in Inpatient Peds

 SAK PASE!!

So I started this post Friday night, it's currently 9:53pm and I just finished going over a block of questions on Amboss. In other words, I'm tired af so I'm definitely not finishing this post tonight lol.......

Okay, so I just finished my two weeks of inpatient pediatrics, I'm starting outpatient pediatrics on Monday at a clinic near where I live and I can't tell y'all how excited I am. Don't get me wrong, I enjoyed my first two weeks but the rotation was in Broward county and it was about an hour drive there and an hour and 10min drive back because of .....SOUTH FLORIDA TRAFFIC. I'll miss the rotation but I will not miss that drive and the gas money I had to spend annnnd the waking up at 6am parts lol. I'm just writing this post to give you guys a peak into a typical day I had in inpatient peds. 

6AM: Okay so I wake up at 6am, not gonna lie, sometimes 6:15am and sometimes 6:25am. The times I wake up at 6a, I usually have enough time to sit down and drink my coffee and eat my breffus. I usually have a parfait for breffus or just plain yogurt and grapes. 

I leave my house at 6:45am on a good day, 6:55am on a bad day lol (bad days being when I wake up at 6:25). I get to the hospital and I'm on the peds floor by 8am always, most of the time before 8. To be on time is to be tardy :)

8AM: My first week, I was with a Family Medicine Resident who was on his peds rotation and another AUC student, she's a 4th year doing her peds Sub-Internship. So she's there for 4 weeks while I was there for only 2. Anyway, the first week, the Resident assigned us each our patients to present to the attending during rounds. So we would log onto the system and look at how many patients are on the peds floor and we would separate accordingly. So for example I would get a new admit and two old patients. The new admits are of course more work and more tedious because you have to look at their chart on the computer then go into the room and interview the parents and sometimes the patient too if they're old enough, then I have to do a physical exam on them. That usually takes some time to get the history. So the history includes the History of Present Illness (HPI), the Emergency Department course/stay (basically what the ED did to the patient before they got admitted to the peds floor), the birth history of the patient, past medical history, meds and allergies, immunizations, family history, and social history. Then, the physical exam. Then finally the assessment and plan. That was a mouthful but I hope I made some sense. 

This is for new admits....for patients who I've seen before I usually do a SOAP presentation,...Subjective info, objective info, Assessment and plan. I do that unless we have an attending that day that hasn't seen that patient at all yet. We usually have an hour and a half to do get ourselves ready before we started rounding.

9:30/10AM -> ROUNDS: All of the Attendings are different. One of them wanted us to present in the patients' rooms (nerve-wracking to say the least), two others had us present in the nursing station area, and one other had us present by the patient's door. So yea, in the two weeks I worked there, I worked with 4 different Attendings. I loved that because I got to experience the styles and teachings of different people. You guys I learned sooooo much from each of them because they each had different experiences to share. In my opinion, the hardest part of presenting patients to the Attendings is the Assessment & Plan part. This part requires you to think like an actual physician and figure out what your plans are for the patient and I always struggle with that part. I also have trouble with the medical terminology. Here's to hoping I get better with time. 

2-3PM: After Rounds is lunch. After lunch, we each get an assigned topic to search on UpToDate, we then have to do a short presentation to the Attending whenever he or she is ready. Then sometimes we go Round on our patients again depending on the Attending. This doesn't take too long, this is just to update the parents and to see how our wittle patients are doing. By 4:45-5pm, its time to go hoooommme! 

The second week was about the same as the first week...except it was just me and the 4th year student, the Resident had to move on to the next part of his training and left us :( The 4th year student helped me soooo much though. TBH if she wasn't there, Idk what I would do. I learned a lot from her. 

THAT'S ALL FOLKS. That's a typical day in inpatient peds. Here are 2 pics just cuz.....





TTYL💜







Monday, September 14, 2020

1st Day of Pediatrics

SAK PASE!!

Yes you guys, another first day. Man I'm tired of firsts lol although I have a lot of more first days to go. First day of my many other rotations, first day of residency, first day of a legit job as a physician, It will never end.

Okay okay, y'all are probably thinking...."look at this girl coming up in here with no apology like she hasn't been MIA from this blog for MONTHS, talking about first days, GET OUT HERE SIS!" 

I'M SORRY! This year has been hectic for everybody, including your girl. I had no updates because Covid ruined my graduation timeline. I was a May student, so I was supposed to take Step 1 in March and start my clinical rotations in May. But instead I didn't take Step 1 until May 18th and I started clinicals TEWWDAY! So now I'm a whole semester behind and to graduate on time I'm basically on a time crunch. But isokay isokay, I ain't worried, God got me and I'm ready to do whatever it takes to graduate in May 2022. 

The elephant in the room....Step. Did you or did you not pass sis? For the ones who follow me on social media, y'all know the answer to that. For the ones who only read this blog, yes I did pass!!! Or else I wouldn't be in my peds rotation right now lol. The passing score for Step 1 is a 194. But to be competitive you should get as high of as a score as possible. Especially as Caribbean students, we need to get even higher than our US Medical school colleagues to even be considered for residency. Maybe after all of this med school business I'll tell y'all my score but for now just know that I did well enough! I didn't get the score I wanted but I'm choosing to trust God instead of that test score cuz I will get to my destination, OKURRR. 


I'm trying to not make my posts too long, because I have a history of writing y'all to death so we'll just talk about my first day and I'll end this post, promise. 

So as you should know, after two years of basic sciences, I had to take Step. After Step is two more years of clinical sciences. Every med student has to do the same "core rotations." Those include Surgery, Internal medicine, Ob/gyn, Pediatrics, Psychiatry. Although Family Medicine is not a core rotation it is recommended that every student take it so I personally put it under the "core" category. After the core rotations, we have the freedom to do electives clerkships. Elective clerkships are subspecialties of those core rotations and this is our "free" pass to do electives in specialities that we are interested in. Part of those electives should include some type of neurology, emergency medicine, those are recommended from what I've read. As for me since, I'm interested in pediatrics, when it comes to choosing my electives, I will choose some subspecialties in pediatrics like pediatric neurology, pediatric neonatology, etc. 

So as of now, I'm scheduled for 3 cores...Pediatrics, Internal medicine then Ob/gyn. *UPDATE: I am now scheduled for the remainder of my cores, Psych and Surgery* All are scheduled in the Miami/South Florida area (also y'all don't know the mess I went through to try to get my rotations in Miami, AUC was trying to send me to Michigan, then New York cuz Covid ruined everything, but that was near darn impossible for me so yeaaa). I'm grateful that I was able to stay down here! More than grateful! 

So 1st day of pediatrics....started ROUGH. The hospital I'm rotating at is about 40-45 minutes away from me, and that's without traffic lol. My call time was 8am, cool. I woke up at 6am showered, got dressed, took some pictures, drank some coffee and ate some oatmeal. While I'm chilling and eating my oatmeal, it starts POURING rain. I started to panic cuz I hate driving on the highway in the rain. But I had no choice. At 6:50am I left my house and started driving. All was well until I got on I-95. I couldn't see clearly at all. I got on the express lanes (I got a Sunpass transponder so I got it like that 👀😜😬😹) so I can get to my destination faster. I'm going 70 mph since its raining I don't wanna go too fast now. Y'all in front of me I see a car spinning in circles 😭. *update: apparently the word is "hydroplanning"* The express lane is only two lanes and my dawg's car is spinning like crazy in both lanes. I was going too fast to stop in time so I'm thinking "okay so this is how I die" but by the time I reached him he stopped spinning and landed on its side or its back in the corner giving me space to pass. I don't even know how it happened, all I know is that I almost died, BUT GOD! I BARELY missed the car. I had tears in my eyes and I texted my dad and my friend telling them how scared I was to continue the drive lol. By that time I was still like a whole 35 min away. As for the man in that car, I pray he's okay. Some cars slowed down to help so I really really pray he was okay. The impact didn't look too intense so I'm hoping he turned out okay.

I continued and of course about a mile later, three lanes were blocked because there was another accident, surrounded by cops and fire trucks and ambulances. FLORIDA RAIN IS DANGEROUS AF. I'm just happy to make out safe and sound man. 

So I'm scheduled for two weeks of inpatient and 4 weeks of outpatient pediatrics. So I'm in the inpatient one now. Today was a hectic day but I've already learned sooo much you guys. I even translated a bit for a Haitian patient's mom. I wish I could share more information with you all but you know..confidentiality and HIPPA and stuff lol. I'm happy with how the day ended. I got cleared to leave at about 4:45pm and made it home by 6pm...TRAFFIC.

Wow, I guess I ended up writing too much gibberish anyway, Damn. Either way, if you've made it this far, thank you so much for reading until the end. I appreciate you.

I told y'all I had a mini photoshoot this morning so here are some of the pics I took lol. 





Lol!


TTYL 💜

Monday, March 23, 2020

AUC 2020 Match List

Sak Pase!

Just came by real quick to upload AUC's match list along with a spreadsheet that the students at our school has for people who matched to post their step scores and where they matched. The link's are below but I while looking at these lists I decided to do some calculations. As an IMG, I have to apply to over 10 times more residency programs than the med students in the states. Yes I said 10x. Consider all else equal, a student in the states can apply to just 10 residency programs and they might get interview invitations for all 10 spots. A Caribbean med student like myself has to apply to over 100 just to get those same 10 interview invitations. I did the math and to apply for 130 residency programs the costs came out to over $3,000. Mind you, this is not including other app fees and traveling/flying/hotel costs. WHAT DID I SIGN UP FOR!? 

Anyway here are the links for your viewing pleasure, just click on them.

AUC RESIDENCY PLACEMENTS

AUC Student Reported Step Scores & Matches


TTYL!