Year 3 in review

Well I didn't do too well on keeping up with the blog. Needless to say, my 3rd year of medical school went by like a blur! Much faster than 2nd year at least! After surgery, I had a great family medicine rotation with Dr. Jack Hawks, who was an AZCOM grad himself. He ran a great office, and I was able to learn much about patient management with him. The downside was the same drawback from all civilian family medicine- there wasn't that much diversity. There was not much peds at all, no OB and very little GYN. There was some sports med, but it was small. Mostly it was adult ambulatory medicine. Lots of HTN, DM, and cholesterol, with flu/colds mixed in. I did learn a great deal about pharmacology, and different management strategies for common cases. There was also drug rep lunches every day, which is a huge perk for civilian medicine! Dr. Hawks was a great doc, and I did like his style of practice. He was very laid back and easily identified with the patient.

In February, I was on OBGYN at Maricopa Medical Center. I am so glad that I did my OB training here, as it was very hands on and lots of opportunities. A huge majority of the patients were from Mexico, and most did not have great OB prenatal care. I was able to do 2 weeks of the "mole shift," or night float. My day started at 6pm and I was on all night and got off at 8am. Then I got to make the 40 minute drive home, and sleep for about 5 hours before going back in. Over those 2 weeks I slept in our closet because it was dark and quiet, especially when Meghan ran her preschool twice a week. But the service was good, and like I said, I was afforded great hands-on training. I got along well with the chief resident and most of the residents. However, I noticed that the morale wasn't all that great there. Maybe it was just the residency, or maybe it's OBGYN in general, but there was a little backbiting too. I also spent a week in clinic, doing mostly prenatal care, with some colposcopy mixed in. And I spent a week on GYN surgery, where I was seeing a lot of hysterectomy and D&C cases. I loved what I did there, and I gained a great appreciation and fondness of the field, particularly the obstetric side. There's something magical about the birthing process, and I was able to share in the joy of the family, and create more enthusiasm in them by sharing my own experiences as a parent! However, I don't think that I could exclusively do OBGYN. It's easy to burn out on, with all the call and long hours. Plus, I do enjoy diversity in my day-to-day schedule.

March was a fun month, as I did my outpatient pediatrics rotation in the greatest place on the planet, Cedar City, Utah! I figured Utah would be a great place to do peds, as there are so many kids per capita! I was at Color Country Pediatrics w/ Dr. Burrows. I was amazed at how much I saw there, for a smaller community. I also came while it was still flu/strep/croup season, so I became quite familiar with a upper respiratory infections. I also saw some more rare conditions, such as histiocytosis, fragile X syndrome, and a cephalohematoma. Megs and the kids came up for 2 weeks. We crammed into the small 1 bedroom apartment that was given to us by the rural health education center who coordinated the rotation. The funniest part about the apartment was that the hallway from the living room to the bedroom doubled as the kitchen. On one side was the sink and dishwasher and on the other was the fridge and microwave. Classic. But it was fun for the kids because it snowed quite a few times while we were there. So they had fun playing in the snow quite a bit. They also really like discovery park!We also got to see some old friends. We really missed seeing Cordelle and Wendy, and Emily and Chris. It was awesome to see Scott Bauman and the women's gymnastics team, too! It was a great month. Especially because during this time, Meghan found out that she was pregnant once more with child number 3! We were so excited!

Then we returned back to AZ for April and I had my ward based Pediatrics rotation at Phoenix Children's Hospital. Let me just saw that that is one of the coolest hospitals ever! All the staff seem to be much happier there than in other hosiptals! The walls are all colorful, there are massive toy trains that go around open gardens. Best of all, the food was awesome, and as a student, I got a card with $1000 limit for the month!! But inpatient peds was a very different experience than outpatient peds. These kids were really sick, very seriously so in some instances. I saw everything from a little one year old with E. coli meningitis, to a 16 year old elite soccer player with extrapulmonary coccidiomycosis. There were obscure things like rat bite fever, to complications of more common cases like mastoiditits. Plus, I got to really work well with the residents, which I really enjoyed. I learned a great deal over this month and it made a huge impression on me. Peds is one of my favorite disciplines of medicine, and I frequently tell people that if I wasn't in the military and I wasn't exposed to the vast diversity that military family medicine had to offer, I would likely go into civilian pediatrics. I was very rewarding, but at times, very sad.

Then I moved on to my final rotation of the year- Internal Medicine at the VA hospital. Despite mixed reviews from some of my classmates, I had a great experience. It was challenging for me, but I got a lot out of it. It was a stark contrast to PCH, as all the walls were white, the hospital was bland, and the staff was not nearly as enthusiastic! That being said, the residents were very helpful, and I was able to see a good bit of pathology. I did see a lot of COPD, along with diverticulitis/osis. Of course, there were trips to the ER for chest pain cases, and many more people had complications regarding their coronary artery disease. I did see a cool Ace inhibitor induced angioedema. My favorite patient was a 61 yo male presenting with cocaine intoxication. After a huge drug binge, he realized her needed help (probably ran out and had no more money), so drove down to check himself into the hospital. He managed to make it to the hospital, but her ended up crashing his car into the flagpole outside the ER! We took care of him, got him cleaned up and after a few days, he was doing well. He said he wanted to check into a program and return to family up north to get away from influences and start fresh. He came back in the next day with repeat overdose. Found out he sold everything he had to get that extra fix. How sad it was.

After the rotation, we had a week of classes, simulated patient cases, and a comprehensive exam. Then I flew out to Philly to take my level 2 performance exam, which tests clinical skills. Each examinee has 12 simulate encounters. We had 12 minutes in with the patient then had 9 minutes to write a soap note. They were very anal in the testing center, and I was rebuked multiple times for showing too much enthusiasm or smiling, or some other means that could be construed as communicating. It went pretty well, though, and it was fun because there were 5 other students from my school that took the test at the same time.

Then it was back to AZ, where I had a few weeks to study for my level 2 written board exams. I studied quite a bit and felt pretty comfortable with what was going on. I walked out of the exam feeling relatively well. However, when I got my results, it was not what I had hoped. In fact, it was lower than my level 1 score. Sure, I passed, but it was not what would be considered a strong score. I was pretty down for a couple days. But Meghan really came through and picked me up. She is always such a great support for me, and she lit a fire inside of me, and convinced me that I will go out into my audition rotations and show them the kind of doctor that I will be, and that I will not let a number define who I become. I'm so lucky to have her in my life.

Also during this time, we had the kids in swimming lessons, so I enjoyed taking them to swimming nearly every day while I was off. Braylei was also involved in many things such as her city gymnastics class and dance class. Meghan also finished her preschool classes in May, and she decided not to teach again for the fall, as she is due at the end of October. And so we got Braylei in another in home preschool. Meghan will still be teaching piano, however. And little Tayscen is just a hoot! He is so full of energy and he can entertain himself for hours if he needed too! I love that little guy!