Moments of happiness

We went though that time of the year again and it was over in a blur. I have gone through my first semester as medical student. I am not sure I realize the work still ahead of me... or I do, but prefer to look not too far ahead so I don't do an indigestion out of it.

I spent the last two weeks of the semester in hospital, shadowing different professionals and physicians. It was just fantastic. Just to get out of the books. Just to realize what it means to work in an hospital. Just for the whole thing... that cannot be put in words. 

My situation/background raised some questions, but never in a negative side, it always generates interesting discussion. I had great feedback from physicians, who told me I will be a great physician: it is always rewarding to get approval and support. I wouldn't decide on my specialty on one day of shadowing, I really enjoyed everything I did (even surgery). And it was so great to see that we already know a lot! We are not necessarily making the links between what we see clinically and what we know theorically, but when the physician explains, I can understand what is happening. The human body is fascinating!

The goal of these two weeks were also to get try to know the patient point-of-view, his reality. Physicians often think they know what is best for their patients, and this is so not the case! I heard someone discussing a study about quality of life of patients, how the patients, the physicians and the families were rating them, and physicians were poor to evaluate what the patient feels. I hope I will remember that when I see patients later...

Then, the new semester began and I went through another unit, about pediatrics and geriatrics. And this is done as well... Tomorrow, I am starting neurology, the first "real" system we study. I am very excited. The second year students tell us it's when you really know if you like medicine. I hope I do!

Finally, things are better at home! My husband has found a job and he is with us for good. It gives me more latitude with schedule... On the other hand, it is more disturbing. Having someone in the house doing stuff while you study is not easy. I am a major procrastinator, so I am easily disturbed. I'll have to work harder to stay focus for the next unit. I use simply noise to phase out the sound around me, it is fantastic. I suggest you try it if you need to concentrate.

The importance of friendship

Last month flew by and I didn't see it... Study, getting Princess from school, dinner, bedtime, then study... That is mostly what would describe my whole month. I feel I now have a routine well installed and I am confortable with it.

I am now done with my second exam. I can't say I was happy with my mark for the first one, but I'll live with it. Anyway, I know I am not looking for a competitive residency. And I like to try to have a life outside of medicine. 

And that is the challenge I am juggling with right now... trying to have a life outside of medicine... My husband is still working in the big city (even though he was home for the last two weeks!), and most of my time is dedicated to studying or taking care of Princess, so it does not give me much time to find new friends. My colleagues are very nice, but clearly not at the same place in life, and it does not fulfill my needs for the close friends I had back home, when I was living in the big city.

Sure, I am closer to my family and let me say, they are there for me, and that count. I am pretty sure I couldn't have gone through the last two months without them. My mom brought me some candies last week to help me studying my exam. That kind of love is priceless...

I knew that friendship would be the most difficult part, and I feel it right now. We are at the cottage for the weekend (fantastic family time by the way, like we haven't got in a long time), and I miss my best friends most during these late Saturday nights... I'll see them in a few weeks, and I am very happy, but we'll need to make new ones, if we want to get through all these years. (And yes, each time I say "but" I think of two of my ex-colleagues, you know who you are!) 

For the next week, I'll be  preparing for clinic practical training, last two weeks before Christmas Holidays. That is going to be very different from the problems of the last three months, and so much interesting and hands-on! In my single-mom situation, it is a little more stressful and need organisation, but I really appreciate getting out of school for two weeks.

And I want to say... to all of you, with whom I had great discussion, I miss you! Give me a call!

What do I want to do when I grow up?

In my program, we work as small groups of 8 or 9 students with a tutor. At my first tutorial in August, our tutor asked us to introduce ourselves. One of the question he asked was "what you want to do when you grow up?" With a bunch of 19 or 20 someting years old, it make sense. When it got to me, he said that I was already grown up... Am I, really? Some days, I doubt it, but anyway, let's leave this unanswered...

However, I still like this question. I think it is interesting to see how our ideas evolve during med school. So, as Medaholic did in his notorious post (http://www.medaholic.com/the-shortlist-year-one/), I thought I would capture my feeling about what kind of practice I would like to have in my carreer. 

There is a lot to think when you choose a specialty.  The most important one (that supercedes all the others) is to love what you do. After that, work/life balance is high in my list. You should also think about the kind of patient-physician relationship you would like. Finally, some advice I got from a friend: think about the specialty you want to do, about the least glamourous part of the job. If you don't want to do that day in day out, maybe it is not the right place for you (Pap test for Ob/Gyn, runny noses for pediatrician, or both for family physician)

I feel that people believe that, because I went to medical school so late in life (and again, it is all a question of perspective), I would do family medicine. I think that, after investing 4 years in this, you shouldn't choose a specialty because it takes a few less years to complete (and again, I might change my mind in 4 years). I truly believe that primary care is the most important one, the anchor of the patient in this difficult healthcare system we have. In my previous life, I have worked with a few of them and I understand that there could be a lot of different ways to practice family medicine. Still, I believe I would not feel that I belong there. I need to be able to find answers to questions (when possible), and not to refer to some colleagues to find it for me. Here's how I see it, family doctors knows a little about a lot, while specialists knows a lot about a little. To be comfortable with what I do, I need to feel that I am in control, and for that, I need to be the expert of my field. I am a scientist in the bottom of my soul, and I want to dig deep to find answers.  So I am not closing this door, but it would not be my first choice if I had to choose today.

There is a lot of specialties, so let see if there are a few that we can discard... After this long statement about primary care, I suppose you can understand that emergency medicine is not what I am looking for.  I don't exactly see the buzz about anesthesiology either... And even though, I try to keep an open mind about all specialties, I have to say I have no interest in surgery. First, I like to have something of a life outside of medicine. Second, I am not very skilled with my hands. I remember working in the lab, using the multi-pipette and having difficulty because my hands where not steady enough. So you can see, it's not not for me... I am not looking forward to becoming a dermatologist either: psoriasis, warts and moles, day in, day out, I don't think so. And I would like some interaction with living patients - there goes pathology. I don't like watching pictures all day long, so there goes radiology.

Let's talk about what I could find interesting... There is a reason my Master degree is in microbiology-immunology and I started a Ph.D. in virology-immunology. It was because I thought the immune system is the most interesting system of our body, and I still think it is. That being said, you can see that I could have some interest in immunology (even though I am not quite sure what kind of practice it involves at this point), rhumatology (when the immune system goes crazy) or hematology (when it causes blood disease). When I remember my time in the lab, it wasn't the best part of my life. However, I believe in balance. All my time in the lab might not be my place, but some time might be very interesting. And that is what hematology could be - real bench to bedside. Microbiology/infectious disease is another one I think could be very interesting. There is so much variety into this one! Can you just imagine the amount of infectious agents that surrounds you? Some of them are so intriguing! From RSV to HIV to tuberculosis, and everything in between. Even though, we know so much about them, we still have to fight hard and the battle is not yet finished... 

So, as of today, and if I understand well how things works, everything I am interested in would be subspecialty of internal medicine. That's my plan for the next year or so... And we'll see as it goes.

Getting there

So, I suppose after my last post, you might think I was going to give up... Well, that wouldn't be me...

Every day seems easier than the day before... First, the house is much better organized. Princess and I are starting to have what looks like a routine. She does homework during weekends, so we don't have too much to do at nights. She found two friends from her class living on the same street, so she feels less alone here. And I am very happy I found a family of babysitters (there 3 of them in the same house!), I am trying the older tomorrow, we'll see how it goes!

As for school, I am starting to feel more comfortable every day with the whole process. I remember the week before I started, I was saying to people that I wanted just to skip to last week of September, to be home, organized and in to it. Well, that's exactly where I am. And I am happy this last month is gone.

Clearly, the problem-based approach is interesting and I am happy I chose this program. However, I can see 2 disadvantages, especially for a single mom. First, you have to work every weekend, because we always have a problem for Monday morning. Even if we have Friday off (which is not always the case), I can't do 15 hours of work in 1 day. Second issue is that if you have some free time one day, because of the way the method works, you can't prepare for future problems. But, other than that, it is very motivating and I believe much more valuable learning than lecturing. 

I had a class last week where we learn to be good doctors, by playing physicians. Even though it is role-playing (and after being a trainer in the pharma world, you know how people hate doing role-playing), it was kind of fun. Our mentor is a young family physician (well, younger than me, but that was expected) and he is very involved. Last workshop was on questionning and it is surprising how it is not easy to do it well. I know I am going to like this class. 

Finally, we had a presentation on medical equipment this week and I felt like a kid in a toy store. I thought only women were interested in stethoscope colors... apparently not. You should have listen to my male colleague discussing the color of theirs... Epic! People who know me would know how I am not a fashion victim (well, I prefer you don't see me now that I wear jeans 90% of the time), but I would love these things to be cheaper, so we could have different colors to fit our outfit... or the way we feel that day! That would be so much more fun, don't you think?

Anyway, I have my first real exam tomorrow, I'll see if I really belong there. I feel pretty confident, and at this point there is nothing more you can do, right? So, wish me luck!

Overwhelmed (and disorganised)

This week has been difficult. It was my first week back at home, being a single mom, since my husband went back to work in the big city. I have to tell you that Princess was fantastic. We usually fight a lot in the morning,  both of us being the opposite of early birds. So mornings in my house is usually a constant fight to get to school on time. But not this week. She was up as soon as her alarm went off, with a great attitude. (it may have help that it is Her alarm that her grandmother bought for her, and that it is pink :-) )

You know how it works... The less time you have, the more you have to do. On Tuesday evening, I had to be in school until 6, while being at the Princess' first dance lesson and at the parent-teacher meeting. There was also another get-together with the colleagues at school. Four places to be at the same time... And that was only Tuesday, it was like that all week.

I suppose being in med school is like a job. I believe you should invest about 45 to 50 hours a week in it. I hear you say, well, that is not that difficult. And I would be incline to agree. 

So, why I am feeling overwelmed? Good question! I am used to being very busy, having lots of projects, so what's the difference? 

I think part of it is the organization. I moved to this new house the week before starting school, so there is still a lot to be done, and there is a lot of unopened boxes. Painting is not done yet, so looking at my living room is very depressing. All the closets are too full and I don't know where to find my clothes (I lost 25 minutes just looking for a pair of shoes). I need time to organize my things, time I don't have because when I am not studying, I am making dinner or driving Princess around or meeting her teacher.

Part of it is also adaptation to med school and the case-based approach. I need to define the boundaries, what needs to be done and what is going too far. In my case, I can't spend too much time on a subject if it is not essential. Time is not a luxury I have right now.

I was anxious to see how it would go with my colleagues. For now, they are very supportive. One of them said to me that I was in the most difficult situation, because they only have to think of themselves, while I have to have a normal schedule for Princess, with real food at normal hours. They are a fun group and I would like to spend more time with them, to get to know them better. I'll make it happen at some point.

Because, I am sure I'll get back on my feet. Things can only get better. But for now, I think I have won the right to an hour of tv!

The first week

After a full week done, I am now a "real" medical student... As in everything, some parts were easier than I thought it would be, and some were a little more difficult. 

The classes.

I realized that a problem-based approach is not necessarily similar in different schools. I used the case-based approach during my MBA; I was expecting something similar... and I was a little unsettled. This approach is very different from my previous experiences. I am not comfortable with it yet, but I am quite sure I will become the expert by the end of this year. I like the way we discuss the case in small group, it is interesting and very motivating to learn from the others. The group dynamic is also interesting to see. 

As a student, I have experienced many types of teaching or learning methods. During my bachelor degree, most of my classes were given by professors lecturing to a big class. Then, I had Journal Club type discussions while doing my Master's degree. I did a short program in the pedagogy of higher education where we did some experiential learning. And I used a case-based approach during my MBA.

As a trainer in the corporate world, I also tried to use different approaches. An adult learner in the workforce does not appreciate lecturing, and this is not an efficient way for him or her to learn either. Therefore, we try to make the learner active in the process. Having been on this side, I know how it is difficult to develop great learning experiences where you control what is learned.

Therefore, I believe I can really appreciate this new approach they are offering us. It is new for me, but not for them since the program has been in place for more than 25 years. They also have a great continuous improvement system in place. After a week, my experience has been very positive... 

Let see if I feel the same way at the end of the year...

Moving on

Last month has been all about moving. Going to the other side of the city is one thing... Packing boxes, cleaning, changing addresses... Moving 5 hours drive from where you live is a completely different story. Once you are gone, you won't come back just to check your mail. You try to do everything from distance one way or the other, it complicates any processes ("you just have to come and sign this form... Yeah sure, I'll be there in 5 hours!") Even though I am excited about my new challenge and starting a new life, this part is not exciting...

My philosophy is to try to find something positive in any situation. So, the good part about moving is giving you the "opportunity" of cleaning - and did we ever!  We recycled at least 20 boxes of school notes... good thing, because the new house is much smaller, less place for useless things.

Princess, my daughter, is less than excited about this move. When we first start talking about it, she was happy to be closer to her cousins. But that excitement was short-lived, once she realized she would be leaving her friends here. For a 6 years old, moving can be very abstract. We tried to have her involved as much as possible. She came visiting houses with us, she boxed her stuff with her auntie... It has been a process to help her move on. She still doesn't want to move, she wants to stay with her friends here. The plans are to keep contact with them by writing them letter (which kid doesn't want to get letter in the mail? You are excited about mail, until you start getting bills...). My hope is as soon as she starts school, a week after the move, she'll have new friends and feel better about this new town.

The friend thing has also been difficult for us adults. We are part of a well-established social network here... It is hard to say goodbye to everyone. For sure, we'll stay in touch. For some relationship, it will be enough. For other, we might loose contact. I suppose this is what we call life...

If we told you to come visit, we meant it...

The start of this story

The first day of my our new life

My life completely changed on May 29th, 2013…

Or, should I say, our life... because I am not alone in this, as I have brought my husband and daughter into this craziness.

Well, actually, it changed the day I decided to apply to med school. I’ve read some of other non-trad premed blogs, and my experience is very different. You see, I didn’t have to go through the process of the MCAT, ECs and all that stuff. Where I am from, universities judge the candidates based mostly on their academic results, and the Multiple Mini-Interview. There is no long process of studying for the MCAT, or having to volunteer for years at nearby hospital.

As long as I can remember, I always felt I would be a doctor one day. But, one day does not necessarily mean one-size-fits-all path. Not for me. I studied, worked, and enjoyed life... I bring different life experiences with me in this new challenge. I hope these experiences will help me in the next few years, but even if they don't, I don't mind; I enjoyed life, and that's the most important thing to me.

I have always loved to learn... Even whilst working full time (and traveling for work all over this big country of ours), I studied part-time and did an MBA. I had fun learning new stuff with people from very different backgrounds. My classes were full of engineers, but also people from community services, and even a priest. This all resulted in amazing discussions in classes like ethics of management or social responsibility of business.

In the next few years, part of my challenge will be to find where I fit in a group of people with very different backgrounds than mine. There is a generation between us, our cultural references are different, but we also have a lot in common. Trying to connect on our similarities and learn from our differences. It is not going to be easy every day, but I am sure it will be worth it!