My One Qualm

Overall, medical school is pretty great. At least that's what I keep telling myself. The workload is insane, your world gets reduced to things in and around med school, the debt is.. well we just won't even go there. But it's a worthwhile endeavor, and you tend to feel accomplished when you pass your exams or impress your clinical leaders. And you're surrounded by 100+ people all doing the same thing, so there's a sense of camaraderie (the people in our class are pretty awesome).

However, I do have one criticism, one qualm if you will, about medical school, and it is this: you constantly feel like you're being thrown from one thing to the next. Unfortunately, I don't really see any alternative. Originally I planned on writing about how the layout and culture of medical education promote this shuttling behavior, and how it hurts students in both the short term and long term. After thinking about it though, I don't really see what could be different. Medical school year one is a strange place. The first semester, you barrel through biochem and anatomy while starting your intro to medicine and problem based learning classes. The sciences are particularly guilty of moving from topic to topic. Granted, they have a lot of material to cover. Unfortunately, you almost constantly feel that by the time you master something, you have two or three new things to do (if you're lucky, only two or three things).

Additionally, you're often shuttled from one topic you've never encountered before to another topic you've never encountered before. The intro medicine class is very guilty of this. For example, we interviewed our first real patients as part of the class. We did this without really knowing what we were supposed to accomplish or even how to do it. And this really gets to the root of my criticism. I think the reason we (fine, I) feel like we're bouncing along from one thing to the other is simply because there's an abundance of information, and we haven't yet developed the filters to manage it yet. It's difficult to know what the important parts of biochem and anatomy are because we haven't had an exam to spotlight where the important details are coming from. Intro to medicine is even worse because we have almost zero knowledge about which questions are important and relevant. So, even when we know what to ask, we have no idea why we're doing it. And strangely enough, we won't even get that knowledge until second year, when pathophysiology is discussed.

But, I can see why we do it this way. First, curricula are hard to completely reinvent so we can only reform parts at a time. Plus people dislike change; blame it on the humans. Second, you can't filter information if you don't have any to start with. If I don't learn how to take a detailed history, I won't know which parts I can skip over or include. If I don't memorize the muscles and there innervations, I won't have the information to make a diagnosis. If I don't know how the cell membrane is affected by deviations in extracellular potassium... well, that one is stretching it. Ultimately, we just have to run the gauntlet and assume/tell ourselves it will work out in the end.

What Beautiful Anatomy You Have

Med school marches onward, seemingly oblivious to the poor souls it's dragging with it. Realistically, we are a boiler, gradually building up pressure until that first exam hits and we burst out the safety release valve. That will be an interesting day for sure.

This week was notable for our first anatomy dissection. Every med school I know of has a cadaver dissection as part of the course, the point being to help us learn anatomy. To say it is an odd experience is downplaying it rather substantially. For one, death is not a topic that is addressed in casual conversation, thus evoking some anxious feelings when it is presented in such an explicit form. Additionally, cutting apart the flesh of the deceased is surreal. Generally, we tend to discourage stabbing other humans with scalpels and scissors and other pointy objects. Making cuts into the body requires you to fight back against decades of rule governed behavior, and even when you do, you still get the feeling that something is amiss. Yet, I certainly wouldn't pass up the opportunity to do dissections, and I know my classmates feel the same way.

Even though we've only had one dissection (two more this week; not sure what we did to earn this punishment), I've already learned a great deal. We started with the back because the muscles are large and it's relatively difficult to screw it up. To get to the good stuff however, required several hours of removing fat from the body spaces. Our body, unfortunately, is quite obese, which essentially acts to increase the amount of time it takes us to remove unimportant parts and ramps up the difficulty in defining the stuff we do want to keep. The other problem with dissection is that most anatomy atlases are color coded. This is great for learning initially, but completely useless for the cadaver. Normal living tissue retains some of its color, but the cadavers are mostly shades of gray. And since part of our grade comes from identifying structures on cadavers, it's kind of a big deal to know what areas you are dealing with.

I'm going to try to touch on some non-med school related topics this week, but we'll see how that actually goes. Now that we're done with orientation, our schedule is a little more regular. Apparently things don't really die down until the spring semester though, so I'm SOL at the moment. Is it too late to change to business school?

Return From Hiatus, With A Bright White Coat

Despite having nearly nothing to do for the past few weeks, I just could not find time to write a new post. It is truly a tragedy. Anyways, some things have changed since we last spoke. Most notably, I have made the transition from premed student to medical student. This was accomplished through a symbolic and somewhat odd ceremony called the White Coat Ceremony. Like a mini-graduation, several of the deans spoke to us and our family/friends/passing hobos about the significance of the occasion and offered advice about how to proceed forward. Then, four at a time, we are called up to the stage and "coated" by one of the deans. This was followed by a recitation of a modified version of the Hippocratic Oath, which was followed (I think) by drinking.

The odd part of the ceremony was two-fold. First, it was inordinately humid out, so everyone was drenched in sweat by the time we finished. Secondly, it seemed strange to hold such an elaborate celebration before we actually accomplished anything. Don't get me wrong, we all got into med school, which is a feat on its own. But I think the ceremony would make more sense between the 2nd and 3rd year. That's the bigger transition, when you go from student in lecture to student in practice.

Regardless, the start of school is still something to be excited about. Unfortunately, most of the week was spent in orientation type events, so we've yet to dive in deep (that changes starting tomorrow). So, what do I have on my plate for the next few months? Well, I've got your standard biochemistry and anatomy courses. We also have two courses in public health and human behavior, one each. Finally, we have a couple clinical med and problem based learning courses. At first glance, it may seem like your ordinary (difficult) college schedule. The deceptive part is that we have multiple lectures per subject per day. For example, tomorrow I have a three hour anatomy block, followed by two hours of lectures in biochem and another 1.5 hour public health lecture. That's how they get you. I have 6 hours of biochem, 9 hours of anatomy (lab starts next week), 8.5 hours of public health, and 3 hours of behavior. And that's just lecture time; many more hours of study are required for mastery. I'm starting to get that fire hose analogy now.

Anyways, I'll try to do better about posting. Maybe I'll even get on a schedule. Consistency is key! Here's to the start of an exciting four years!

The Beginning

I know what you're thinking. Does the world need another blog about medical school? Have we not already exhausted the finite number of ways to describe the endless studying, the mindless scut-work, the boundless financial debt? Will my material be as repetitive and lackluster as the examples I just provided? Probably. As a traditional applicant, the journey through undergraduate, medical school, residency, and beyond follows a well-traveled path. A somewhat rocky and winding path, but highly traversed nonetheless. It is not my intention to revolutionize this journey. But I do hope to add my insight and experiences to the burgeoning collection, partially for myself, to reflect upon and organize my thoughts and beliefs, and for other students, to help them develop and navigate through their own adventures.

I am not the first to use a medical acronym in the title of my blog (not even the first to use this acronym). But I believe it accurately summarizes what I hope to accomplish. The SOAP note is a quick way to describe the management of an individual patient. Its constituent parts are Subjective (anything the patient reports), Objective (anything the physician can report), Assessment, and Plan. And so I plan (I'll hit each one, don't you worry) to populate this blog with my own musings and anecdotes on matters that are relevant to myself, other students, no one in particular, or no one at all. Whether they are experiences with people or the idiosyncrasies of medical education, I hope to infuse humor when appropriate (and a little bit less humor when wholly inappropriate) to make each story enjoyable, or at a very minimum, tolerable. Periodically, I also plan on including interesting scientific information or facts pertaining to the study of medicine, from pre-medical to post-graduate. And because I hail from a behaviorist research lab, I will sneak tidbits of behaviorism and psychology when I can. Humor will accompany these facts and theories, although it will be of the dry variety and quite possibly not funny to anyone other than myself and those who assume Fargo is a comedy. Now the assessment is trickier. It will tend to show up when I am trying to make a point or provide a moral to a story.

And so we come back to plan. As I await the beginning of medical school, my plan is to provide a review of the application process, as well as spend some time recounting a few of my more substantial pre-medical experiences. Once August rolls around, all bets are off.

-Liam



Note: In the event it appears this blog appears abandoned, enjoy the content I managed to provide.

Note: In the event the blog is abandoned because I was murdered under suspicious circumstances, I can assure you there is no hidden message present. Also, please enjoy the content I managed to provide.