New First-year Resident Working Hours

It's almost a rite of passage for residents to be overworked and sleep deprived. Back in the days when my parents were residents, they spoke of the times they had to work 36 hour shifts. Nowadays residents find themselves working 24 hour shifts, but starting Friday, July 1st, first year residents will start working 16 hours shifts. Progress in the right direction. Although it's a small victory, it's a victory nonetheless. The American Medical Student Association (AMSA) is still working to reduce the working hours of ALL residents.

To read the full article, you can find it here: http://www.amsa.org/AMSA/Homepage/About/News/062911.aspx

A New Perspective on Medical School, and Good News: I've Honored my First Class!

I've officially Honored my first class in medical school! woo! I know it's just Biostats and a ton of people honor it as well, but it still feels good to say it. 

I set a goal for myself when I started second semester and I realize now that I never shared it with any of you reading my blog. Once receiving my final first semester grades back in April, my first emotion was relief that I passed all my classes (not that I was ever really in danger of failing anything), but as the weeks wore on, a new feeling crept up. I didn't notice it at first; I was too distracted with all the hoopla from my family and friends, but when things calmed down and I was left to quietly reflect on my lonesome thoughts, I felt it.  That feeling, captive readers, was disappointment. A little unhappiness too, but overwhelming disappointment. How did I let first semester get away from me? That's what I kept asking myself. Later on I just reasoned that fine, it was only the first semester of medical school; it was an adjustment period, anatomy blows, and now its done.  How about making up for that lackluster performance next semester? And then I set a goal for myself to make Dean's List.

In order to make Dean's List at AUC, your grades for that particular semester need to average to an 87% or above. To honor a course, you need to have a 90% or higher. I never really expected to honor all my courses, but I felt an 87% average was definitely a reachable goal for me.  So maybe some of you are asking now why does it even matter? Scores in med school is pretty much Honor, Pass, Fail. That school of thought also runs with the following joke I know you've all heard time and again:

Q:What do you call someone who graduated at the bottom of their med school class?

A: Doctor

Hardy-har-har. 

This belief only begs the question, what motivation is there to excel if it won’t matter? 

But it does matter. I've met some US med schools students who've asked this question and I've read a couple of blogs from people who pose it as well. They talk about the pass. They just want to pass, they are going to blow off the first few weeks and then spend that last one studying so they can just pass. To be honest, I was all about that pass first semester and then I realized...wait a sec.... I'm in the Caribbean... I'm not really allowed to "just pass". Damn stigma! Or Maybe it's more accurate when I say I'm not allowed to "just pass" to get to where I want to go and that is ultimately a Pediatric Neurology residency somewhere in the Boston/Providence area. People don't mess around up there. When I look at the AUC match list no one ever goes there, no one gets matched up there.....  I don't know if it's because they don't apply or if the competition is just that fierce in Boston in particular, but I know that "just passing" isn't going to be enough for me. 

What it all boils down to is this: I need to do well now, so I can do well on the USMLE Step 1. And also, I need to do well now, so I don't look like a driveling fool during clinical rotations. 

The way I see it (and probably not the best way to look at it), the first two years of medical school is pretty much a very long, overwhelming and extremely expensive Kaplan course that prepares you for one of the most important exams of your life-- the USMLE Step 1. If you aren't understanding the information now, when exactly are you going to learn it? Please don't say during breaks or the review month right before the exam. You have to learn the material when you are learning the material in class because there just is not enough time. Everyday you are learning something new, every block you are moving on to another part of the body, every semester you are tackling completely new subjects, and in med school you just keep trudging forward day after day for two years and it's very hard finding the time to look back.

Personally, I can't help but feel I missed the boat on a lot of the stuff in anatomy and embryology, and I will have to spend time looking back/actually learning about those subjects again, but I can't let that happen with anything else. I am putting every ounce of my resolve into everything this second semester and there hasn't been an instance yet where I felt like I've missed something. It is important to do all this work now because when the time comes where I have 4-6 weeks to review for Step 1, I want those weeks to be just that-- a review. I want to say, "oh yea, that's right I remember that" or, "oh yup, definitely familiar with this" when I study those few weeks. Not "oh my god, what is this, why do I feel like I've never seen this in my life???" or "Oh yea, I remember this, I failed this block." That would not be good. No one wants that. In conclusion, work your ass off now to get the best possible grades these first two years, and everything will payoff when the boards and clinicals roll around.

That is all for now,

Andrea

A Typical School Day at AUC

"Anonymous"  commented on my last post asking what the average day is like here, soooooo......

For the first four semesters at AUC, the schedule is pretty standard:

-Wake up around 7-7:30

-Get to the first class, which goes from 8:00 am to 9:20 (you get a 10 minute break in the middle)

-10 minute break

-Second class from 9:30 to 10:20

-10 minute break

-Third class from 10:30 to 11:20

And from here on out the schedule changes depending on which semester you're in. 

~First semester, you will have a break for 2.5 hours and then you will have anatomy lab from 2:00 till 4:00 pm. 

~For the first month of Second Semester, your classes just end at 11:20 and you have the rest of the day to do whatever you want. After the first block exams, however, you have Biostatistics class from 12:00 to 12:50 for one month. My class just took the final exam in biostats this past week, so we are now back on the schedule of free afternoons!!! Sadly, we will have those afternoons taken from us once we start Intro to Clinical Medicine (ICM2) at the beginning of block 4. 

~I'm not entirely sure what the schedule is like for the other semesters since I am only a first year medical student....

In the afternoons I just study, study, and study. And that's pretty much how it is with most people here. I'm sure if you are the health-conscious type, you will find time to incorporate a workout or run in the middle of your day, but I study in the afternoons so I can have the evenings off to watch TV shows/sports/movies and to video chat with my boyfriend. I'm pretty big on sleep so I'm almost always in bed by 11:00 p.m. 

Oh and I almost forgot to mention,

Everyday in the evenings from 5 pm and 7pm there are tutoring sessions to help you go over all the material  that has been covered in class and to stress what is high yield for the exams. The tutors are always students from the class ahead who excelled in the course. I feel like most people do go to the tutoring sessions, but I've only been once myself. I don't find the sessions helpful because I'm just more productive when I'm home reading the slides over myself. I like going at my own pace and concepts stick to me more when I'm reading rather than listening. Although I don't go to the sessions, I've recently started using the tutoring slides when writing out my notes. The MCB and Immuno slides have been very good this semester at highlighting the material most often tested in the exams. A+ with those.

Related articles

• AUC First Semester Classes (medschoolcarobstyle.com)

Medical School is a Balancing Act of Priorities

In decreasing priority:

1. Study
2. Stay in contact with BF/ family
3. Sleep
4. Spend time/ decompress with friends
5. Blog
6. Exercise
7. Get a tan

One factor is inversely proportional to all others meaning if I spend more time studying, I'll spend less time sleeping. On a good day I can get three or four of these things done above, but there just isn't enough time in the day for me. Usually my exercise and blogging habits take a pretty big hit in my daily routine, and tanning? Ha! I'm lighter here than I was back home.

Semester 2: Block II Results and my Newfound Study Method

Like I said in my last post, I didn't do poorly this block, I just didn't do as well as the first (I know I sounded like a whiny little bitch). But I guess I shouldn't have been surprised since Block I is the easiest of the semester. Since the end of March, my grades have been steadily improving.... until now. I regressed, but only slightly.

Immunology-

Average: 84%

Me: 88%

Physiology I-

Average: 81.5%

Me: 83%

MCB II-

Average: 82.5%

Me: 88% (I didn't initially do this well, he threw out three questions that everyone got wrong)

Biostatistics-
Quiz 1+ EC=

Average: 78%

Me: 114%

Quiz 2 + EC=

Average: 83%
Me: 90%

My Biostats final is next Wednesday. With the quiz grades and extra credit I'm going into the exam with a 102% average. I cannot wait to be done with this 1 credit course.


At least a "bad" block for me right now isn't me failing an exam like first semester. At least I have balance, which wasn't the case last semester when my grades were pretty much A, B, F.  If you guys remember from my earlier posts, the first 3 blocks, I failed three different exams. First Block I failed Anatomy, second block I failed Histo, third block it was MCB. To put it plainly, I was a disaster. Fourth block was the first time I didn't fail an exam. It was at this point I discovered my study technique....

I no longer listen in class. I doubt this will work for everyone, but the kind of learner I am... I need words. I need to physically write words. Over and over again. And to read them over and over again. I can't listen in class. I just can't do it. I don't have ADHD, I just get so overwhelmingly bored, time crawls. I  would day dream, doodle, even bring my computer to class just to surf the web. It was stupid. I tried very hard in the beginning to listen, but I can't learn when I'm listening. I was wasting 3.5 hours of my day in class so then I decided 4th block, forget this I'm just going to sit in the back of the room with my headphones on and study on my own while class is happening. And that's what I did and what I still do everyday. That's it. And it's been brilliant.  I write notes on the margins of the slides while I'm in class and once I'm home, I write those notes again in a notebook or I'll convert them into flashcards. When Block weekend rolls around, all I do is read from those notes and flashcards 3 or 4 times and then I'm set. And what's particularly nice about this method is that I save time and don't need to spend as many hours studying at home like most of the other students in my class. After classes, I probably study for four more hours and then take the evenings off.

I think I may tinker with the method I've been using and start writing the actual notes into my study notebook (or flashcards) while I'm in class from now on, and then when I'm home I can just read over my notes again and again and memorize them for that day. I'll let you know how it goes for me. I hope this is helpful to everyone!


Related articles

• Semester 2: Block I Results (medschoolcaribstyle.com)

Frustration

I had block exams yesterday and they went fine. I'll be more than happy to share my scores with you once the final grades are up, but from the raw scores I can already tell you I didn't do as well as I thought. Going into all three exams, I thought I knew the material inside/out and I was going to ace all of them. Wrong.

Immunology was my best exam, but it turns out I know next to nothing about "Immunological Techniques." Of the total 40 questions, 5 pertained to this particular lecture and I missed 4 of them. I just stopped by  my professor's office hours to go over my missed questions and I really did have gaping holes in my understanding of the different immunological tests and what they mean. Hopefully those gaps are filled now. In all, Dr. B's exams are extremely fair and I feel thankful to have her as a teacher.

The same can't be said for my current MCB professor, unfortunately. Of the three classes, I felt like I knew MCB the best. And I believe if I actually had a reasonable and fair professor, my exam grade would have reflected that. Irrelevant is the term that comes to mind when I think of this last MCBII exam and it's a crying shame too since I know all the material that is actually important. I could write the pathways for glycolysis, gluconeogenesis, glycogenesis, I knew all the enzymes, their coenzymes, their activators, and inhibitors, how/when/why they were phosphorylated, the amino acid residues that get bound, all the details about the diseases, and that was not nearly enough. I knew the important concepts and details he emphasized in his slides and in class .... but noooooo the detail that he mentioned once in passing is what ends up on the test. Example: He would have a slide and all the important material is bolded or in colors and what not. What ends up on the exam? The little black letters at the end of the page that are in parenthesis. Yup. He fucking did that.
BLAH BLAH BLAH BLAH IMPORTANT!!! KNOW THIS FOR The Rest of Your Life!!!!! THIS WILL CURE AIDS (but this is what I'll test you on)

Do I sound petty right now? Probably. I think I even sound petty complaining about a grade that I know isn't actually that bad. It's just frustrating  to put all your effort into something and not get the outcome you think you deserve.  There is literally nothing more I could have done for this exam. What I knew going in was the most I was ever going to know regardless of whether I spent an additional day or another week learning the material. The problem with putting your all into something and not getting anything out of it is you start to lose hope; you question why put this much effort when it doesn't make a difference?  And that attitude is poison to a student, especially a student in medical school when failure really isn't an option. If I hadn't studied as hard as I did, I would have most likely failed this exam and where would I be? In a hole.  I need to try and stay focused now. I've aired my grievances and I thank you all for listening to this rant.  It's just very disconcerting to find out that my best may not be good enough.

The Agenda for Tomorrow

As I mentioned in my last post, we don't have class today! Instead the school is holding a teaching symposium for the faculty and tomorrow we will be having a series of student information sessions (all of which are optional) from 12:30-6 on the variety of topics listed below:

I'm using my day off as a catchup day since I'm still behind in MCB and hopefully by tonight, I will finally be caught up in all my classes.  It will be nice to have some peace of mind so I can focus on the lectures and Clinical Symposium tomorrow. We still have morning classes but at least Biostats will be cancelled (woo). I'll post an update of the events as soon as possible.

I think I forgot to mention.... it's block week again and I'll be having my next round of exams next Monday. It's going to be a crazy week. 

Happy Ascension Day and other St. Maarten Public Holidays

Who knew St. Maarten was religious? Today, June 2nd, is Ascension day, the day that the resurrected  Jesus ascended to Heaven. 

For those who aren't religious (like me), this day is particularly nice because we have no class! I don't think I've had a single day off from school since I started here in January and looking at the official dates for St. Maarten Public Holidays it seems that I missed Easter and Carnival by a couple weeks.

So what have I been doing this day? I slept in till 10, woke up and did some studying for a few hours.... I'm pretty behind in Immuno and MCB at the moment. Then I went outside to the pool for a couple hours. I just showered and before I start round two of my study session today, I figured why not keep my roll going by adding another blog post.  Below is the full list of St. Maarten Public Holidays i.e. no class! My next day off is actually next Tuesday, but that's only because AUC has its huge Clinical Symposium where reps from all the affiliated hospitals come and talk about their programs.

Image via Wikipedia

Maho Beach

Public Holidays

New Year's Day - Jan 1, 2011
Good Friday - Apr 22, 2011
Easter Sunday - Apr 24, 2011
Easter Monday - Apr 25, 2011
Carnival Holiday - Apr 29, 2011
Queen's Birthday - Apr 30, 2011
Labour Day - May 1, 2011
Public Holday - May 2, 2011

Ascension Day - June 2, 2011
Emancipation Day (new)- July 1, 2011  St.Maarten's Day Nov 11, 2011
Kingdom Day - Dec 15, 2011
Christmas Day - Dec 25, 2011
Boxing Day - Dec 26, 2011
New Year's Day - Jan 1, 2012 

Day Trip: Pic Paradis, Orient Bay, and Maho Beach

Since John's been here, it's been a bit of a challenge finding time to do some of the activities I had planned for us considering I have class and a lot of material to study each day. For the first two weeks of his trip here, I'm sorry to say I didn't take John anywhere beyond Simpson Bay, but I promised him we would take a whole day to go around the island after Block 1 exams.

John and our friendly guides in the background.

The first Wednesday after blocks, John and I rented a car from the "Thrifty" booth in Sapphire Beach Club ($30 for 24 hours and only a two minute walk from where I live) and  Pic Paradis was first on our list of stops. Pic Paradis or Paradise Peak is the highest point on St. Maarten standing 424 meter (or roughly 1400 ft) and is located at point A in the map below. To get there, you are required to take an extremely narrow and steep dirt road for ten minutes. There were times I didn't think our car was going to make it. Also, we were a bit wary making the ascent because of the number of people on Trip Advisor who complained of being robbed up in Pic Paradis. Going up the one lane road and not encountering another living soul was unnerving to say the least. I kept having this recurring thought that we would make it to the top, seemingly alone, only then to be pounced on by machete-wielding robbers hiding in the bushes and demanding our money.  We made sure we didn't bring more than $40 for this reason. The only other valuable I brought on the trip was my camera and I figured I wouldn't be too distraught if this was stolen from me.

The hike.

I'm happy to report that we weren't robbed and we actually weren't alone on the eerie summit. The moment we arrived to the path that takes you to the top, we met a British-American couple who were residents of the island and they told us to go with them. I gladly followed since I wasn't sure what was next from where we parked. The following step in our small adventure was a quick 5-8 minute hike through the wilderness. We finally got to the clearing where the radio towers stood.

I took a bunch of pictures, but here are some of the nicer ones below.

Us

Kakao at Orient Beach

Boat Bar on Maho Beach

 Next on our journey around the island, John and I drove to Grand Case and continued on until we arrived to Orient Beach point C on the Map below. The moment we got down from the car it started to pour like crazy so we took cover at the Kakao Beach Bar. This was actually the place I was supposed to have New Years Eve with my parents when I first arrived to the island, however we ended up next door at Bikini Beach (and glad we did too. Best meal I've had on St. Maarten/Martin was at Bikini).  Both spots are beautiful nonetheless. They are fantastic semi-outdoor restaurants/bars located just a few feet away from the ocean and there is no better place to sit and have a few beers. And that is exactly what John and I did until the rain died down. (p.s. there is a nude beach at the very end of Orient, check it out if you're into that)  

You've been warned!

We started driving south again, saw some of the cruise ships, bypassed Philipsburg (point D) and all its lovely traffic and got all the way around to Maho Beach (point E). If you're ever in St Maarten, the one thing you must do before leaving the island is sit on Maho beach and wait for a huge plane to land.  John and I had a couple of surprisingly delicious rum strawberry/mango smoothies at the "Boat Bar" (I guess? it is a boat that was turned into an outdoor bar) on Maho Beach and waited for the planes. We sat there for an hour or so and after watching a couple planes land we headed back home. Perfect end to a great day.   

Sunset at Maho Beach

Map of our adventure:

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