Thursday, 31 December 2015

The Year That Everything Changed

It's only natural to think about the last year on New Year's Eve. I don't make resolutions, but I do reflect. 

This time last year, I was still worrying a great deal about whether I would ever get into medical school. I had only had my MUN interview and didn't yet know if I'd be interviewed at any of the Ontario schools. 

And here I am, purple backpack in my room, two years and five months away from adding an M.D. to my name. 

This time last year, I was happily, if somewhat anxiously, pregnant. It would be only two days later that we'd get the bad news. A year later, we're no closer to expanding our family, but we have hope. We've got an appointment with a reproductive endocrinologist next month. I can finally get the assessment that I've needed for years but haven't been able to access. 

A year ago, we were living happily on the Island, with fantastic, if exhausting, jobs and a generally stable, but modest life. We're now in Hamilton, with far more neighbours than we're used to, in a city far larger than we're accustomed to, and which we were very hesitant about living in, but which has surprised us with its nicer side. 

This year has seen me grow as a person in many ways, partly as a result of accepting my role as a student physician and the position that will place me in my community, partly as a result of breaking away from some unhealthy relationships. It has been an experience, for sure. 

I don't know what next year holds, besides the start of clerkship, a trip home, and possibly our first ever international vacation, but I do hope it will top this year. Hopefully without any of the tragedy that touched the start of 2015. 

That said, I will always remember 2015 as the year that changed everything. What an extraordinary thing to be able to say. 

Happy New Year everyone. If you are out, be safe in your enjoyment. If you are home like we are, have a fantastic night. 


Friday, 25 December 2015

Quiet

We don't celebrate Christmas, but I do like the quiet of the day. Took the dog out for a walk (didn't even need gloves!) and it was quiet even along the busy road. I've taken a bit of a break from blogging for the last week and a bit just to spend a bit less time online. 

Simply by coincidence my husband has six days off in a row, starting yesterday, so he's got a little mini vacation. We're enjoying the time together as a family. Friend of mine stayed with us over the Solstice and it was really lovely to have someone come stay for a bit. We didn't get out to do much, but she got some time to relax after the strain of her second last semester of undergrad. 

I made an amazing meal on the day of the solstice, if I can pat myself on the back a bit. Roast and vegetables - potatoes, sweet potato, carrots, beans - and fresh bread and chocolates and pumpkin pie. Oh man was it wonderful. Literally the best gravy I've ever made and I make pretty good gravy if I do say so myself. 

My kids are going slightly insane with the deviation from their usual schedules, but that's to be expected over breaks. We're currently looking into what to do with them during the March break and then over the summer. My son wants to go to computer camp to develop his coding skills. Yup, he's an eight year old programmer. Or at least he's trying to be. He's been able to write a few simple programs that request and read back input. 

For his birthday, which is in three weeks, we've gotten him a book about using Python (that's the language he's chosen to learn) to modify Minecraft.

My daughter has been running around with her stuffed Dalek, using her sonic screwdriver (the Eleventh Doctor's) on everything. Scared the crap out of the cockatoo when she pretended to open his cage with it. 


Watching Doctor Who, naturally. In Superman pyjamas. Because that's how we roll in this house. 


Of course we got him a cool, light-up keyboard. That's the best part! He's totally in love with his computer. 
And yeah, he had to assemble it. 

As much as I love medical school, I am incredibly glad to have this time off. I needed it desperately and I feel so much more like myself. 

Or at least I will once we get a proper night's sleep at the right time. Last night was a chorus of vomiting thanks to a stomach bug, so it'll be good when that is all gone. Everyone seems to feel okay today, at least. 

I wish those of you who celebrate it a merry Christmas and hope all of you have a lovely day. 



Tuesday, 15 December 2015

Nice Spring We're Having This Winter

The weather has been confusing me. It's awfully warm for December, though back home they are having their usual snowstorms. Exams at my old school were cancelled today.

The early nightfall is certainly starting to get to me. I'm looking forward to the days starting to get a bit longer because right now I'm having a bit of a rough time focusing. Fortunately I only have two more things to do this week in addition to the CAE tomorrow morning. I just have clinical skills 'super Wednesday' and then tutorial.

The purpose of our triweekly 'super Wednesdays' - where we are taught clinical skills by a more experienced instructor - is to ensure we are all progressing at the same rate. I like that we do it this way because it helps eliminate any possibility of falling behind, though so far I've had really lovely preceptors who have been very concerned with ensuring our clinical skills progress as they should.

We aren't going to have our normal weekly clinical skills this week and it's partly my fault. Our residents weren't available on the days that worked for most of the group, and the days they were available had at least one student who couldn't make it, so we decided to just do a double session the week we come back. This is something Mac allows occasionally, at the discretion of preceptors.

So we're told anyway.

It was rather nice of them, especially considering that the reason I'd rather not go on Friday evening (and I'm the only person who doesn't want to do Friday) is because we're taking the kids to see the new Star Wars movie. We bought the tickets months ago. It's opening night and we've all been looking forward to this film for years. I am extremely grateful that my team didn't ask me to miss it. If we'd had clinical skills, 'I'm going to see a movie with my family' isn't really a good excuse for not going, so I'd have probably had to flake on my family.

I'm still unsure a lot of the time about planning stuff a way out because of this. Because we only get our MF schedules a couple weeks before the MF starts, I can't really plan things more than a couple months out at most and sometimes it's necessary to have more lead time to book things. Right now, I don't know my schedule past February 12th. Makes some things hard.



Sunday, 13 December 2015

I've been scooped

Haha, this popped up in my Facebook newsfeed today and I'm very amused.

It's an article about a just-published paper (last week) about an association between mothers with PCOS and children diagnosed with autism. The hypothesis is that prenatal exposure to increased androgens may alter neural development in such a way as to contribute to ASD. The paper is in Nature, you can find it online.

The reason I'm so amused is that back in 2014 I had this exact same hypothesis. I was thinking I'd have liked to make an honours project out of it.

Can I say "called it?"

I realize that this establishes only an association, there's no causation determined here, but it's still really cool to see that real researchers who shared my hypothesis actually found that the evidence supports it.

Had I actually been in the process of doing actual research on this, I'm sure I'd have been annoyed by the fact that this was just published, but I'm actually a bit giddy about seeing it to be honest, because it makes me realize that yes, I do actually have an okay grasp of this stuff.

Saturday, 12 December 2015

Not A Good Day

Today was not a good day. 

My daughter is using some of my son's attention-seeking behaviours and it is intensely frustrating. She's seeking attention because I'm so caught up trying to deal with my son. 

Usually, I am able to balance this. But today, I'm trying to get the house into order because my friend is going to be here in a week to celebrate the solstice with us. I'm excited that she's coming to stay for a bit but my slightly obsessive need for the house to be perfect before her arrival means I'm rather anxious at the moment. My husband is working this weekend so I don't have any backup which makes it hard to get anything done. 

I need to do my tutorial prep for Monday because I have a doctor's appointment in the morning so I can't do any fine tuning that day. I also have a CAE on Wednesday which I'm not terribly nervous about but still would like to do well on. 

I'm basically busy until Thursday evening, and then I only have part of the day Friday since we're taking the kids to see Star Wars: The Force Awakens that night. My friend arrives the next morning and I'll be driving to Pearson to get her, so I basically need to be done by Friday at lunch time. 

At least this is my last week before the break. And at the end of next month we have a bit of a mini holiday when we head to Winterlude for a few days.

Hopefully the week doesn't prove as stressful as it seems it will turn out to be. I am desperately in need of a proper break. 


Thursday, 10 December 2015

Let's get clinical

I hesitate whether to post this because it may come across as a touch negative, but really only inasmuch as it reflects on me, so I think it's okay to post.

Tutorials, while very important for building the foundations on which our medical knowledge rests, are not my favourite part of school. Particularly coming into MF2, where we have all been in different groups and all done things differently prior to now. We're still working out how to work together and I can see some areas where I'm having a bit of a harder time fitting in.

I use clinically-oriented resources (like Merck and UpToDate) instead of weighty texts that spend chapters expounding physiology at a level much deeper than our needs. One, because I don't have as much time to spend reading bulky work, and two because I actually have learned a lot of that before (thanks to having taken two physiology courses, human anatomy, endocrinology, immunology, and neurobiology all within the last two years) so often I really only need a refresher. We absolutely do need to know body systems in depth, because that's sort of what being a doctor is, but there's a limit to that depth.

Pretty much every single lecturer has said something along the lines of "I could go on for days about ____ but here's what you really need to know." I have used their information as the general guide to my learning. That and questions from licensing exams. Not that I'm trying to teach myself to a test, but because that gives me a ballpark for what I'll actually need to know as a doctor.  I make sure I'm meeting my learning objectives, and I am satisfied with that. Medical school is like 'drinking from the firehose' to borrow an expression from a book about information overload, and we need to be selective about what we learn because we simply can't know it all. Part of Mac's program is us learning for ourselves what we need to know.

But the fact that I have prepared in less detail than others (even though I have met the learning goals which means I am doing enough preparation) means I feel more than a little... inadequate contributing in tutorial. I think tomorrow I'm probably going to be pretty quiet (the fact that I have laryngitis at the moment will probably ensure that, actually) because last session I managed to stumble over myself because I was feeling so very not confident that I'm pretty sure I came across as an idiot even though I actually did know what I meant to say. I'd lost half my preparation time and notes because of having to completely reinstall my OS on my computer and I was completely ruffled so I misspoke several times and I hate doing that.

MF2 isn't getting off to a great start, really. Not that there's anything wrong with my group members, they're lovely, really. I just feel very unsettled and I'm really, really looking forward to the two weeks off I've got coming up.

Tuesday, 8 December 2015

Narrative

Procomp today was about narrative medicine.

I think we can say I have some experience with this.

So we had an exercise where we were supposed to respond to a prompt by writing whatever we thought for eight minutes. We read them to our groups and received feedback. No editing, no pre-amble, and no commentary (from ourselves) afterwards. Just let the work stand on its own.

The prompt was  "write about the rules for being a medical student."

So I did that. We get to keep the works and don't have to submit them. I'm going to post mine here, only very slightly edited for flow, and with one sentence inserted (I've italicised it), because I enjoyed the exercise, even if I don't think it's my best writing ever (or even terribly good, but it's not horrible.)

--------------
Be extraordinary, it seems, is the overriding theme of this whole experience. Most of my peers are successful and experienced academics, but I have only ever been ordinary. I am happy with ordinary. With tea on the deck at sunrise, evenings out walking the dog. I'm happy to see my children every evening, to share their days with them. I don't need to reach higher, to make a name for myself with my career, to find what will fulfill me. I've found it.

Be humble. Listen to your elders. Do as you are told. But learn so you can question, question so you can learn. But see where you are, know what you don't. Find your feet below you and reach out to meet the path but, extraordinary though you may be, acknowledge and respect the feet that trod the path before you.

Be aware. Of yourself, your patients, their knowledge. You don't know everything. You can't know everything. Let them teach you. Let yourself be taught.

Be yourself. But not too much. Know where and when you can let yourself free of the white coat with its Sisyphean demand for perfection. You may need to be more than you think you are. But listen. Learn. Be led by your inner learning creature who speaks to you in the quiet places where your doctor self breaks.
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I took rules in a more figurative sense. The rules we internalise, not the rules that are posted on the wall.

It was definitely fun to do. I had to have a bunch of ventolin this morning so my hands were shaking really badly as I wrote and it's barely legible, but I somehow can still manage to read it.

We should do more exercises like this. Though I expect my classmates may disagree.

Sunday, 6 December 2015

Trip!

Even though we'd thought about making the trip here our first real family vacation, we sort of didn't end up doing that. We spent the first few weeks getting to know the city and the area, but ultimately we didn't end up actually having a vacation the way we'd hoped.

So we still haven't had a proper vacation of any sort.

Next month, that changes.

It's basically a long weekend away since my Fridays are flexible. The kids have school but I think for a once-a-year sort of treat, it's not a huge deal to miss a day of school. We've actually had only one absence between the two kids this year so far, anyway.

We'll be leaving the Thursday night and coming back Sunday night and we're staying at a hotel to make it special. Got a really wonderful deal on a little suite.

Just have to arrange to have someone come in to check on the cats and birds, and we'll board the dog.

I'm really, really excited. This'll be our first vacation of any sort as a family. We'll be going home for a week in the summer and, if I am selected for the family med sponsorship next fall, my husband and I plan to head to the UK for ten days or so at the end of the year. The sponsorship is enough that I won't need to accrue much if any new debt for the remainder of my education and I'll be able to start paying off the LOC in residency (and I project I'll finish by the end of my first practice year.)

I figure a fun international trip at that point is entirely justifiable, eh? Most of my peers take trips. It's just that trips for us are more expensive because there's more of us which is why the one we're taking next month will be our first.

Life is pretty good these days, I must admit. Really need to get around to doing my tutorial prep for tomorrow. Coeliac disease. Woo.

Thursday, 3 December 2015

Lab Results

I posted before that my family was being investigated for genes associated with a certain type of inherited cancer due to the fact that we've had three (at the time it was thought four but one turned out to be a misdiagnosis) cases of a rather uncommon cancer down one side.

The genetic study took a very long time to get back but apparently was completed sometime in the last little while.

By choice, my husband and I generally have no contact with my family of origin anymore. Sometimes, it's the healthiest decision you can make. However, if our kids request to speak with my parents, we let them. Otherwise, we don't initiate contact and neither do they.

A couple weeks ago, my son asked to speak with them so we let him FaceTime. During that call, I was told that the genetic testing indicated we do not have the inherited kidney cancer genes, but that we're supposed to start getting mammograms in our thirties, so there is some cancer-associated marker, but I don't know what it is specifically.

On the plus side, if I'm going to have a gene predisposing me to cancer, whatever this is is probably preferable to the rather scary ones that were high on the suspicion list.

I'm rather glad I don't have a crazy high chance of ending up with kidney cancer. I can live without both breasts, not so much with the kidneys.

For once, I'm not in the weird subpopulation. Woot!

I've just had a pretty thorough evaluation as baseline stuff for my new family doctor, and to accompany the referral to the fertility specialist (I didn't act on the original referral I had; we decided to wait until we had OHIP, which will cover some assessments.) I have had a ton of blood work done, an EKG, and I have an ultrasound on Monday just to make sure everything is okay. 

The cool part about the lab I went to here is that they post your results online as soon as they are done. I just had the draw at noon and already have several results back, which is pretty cool. My doctor checked off the 'prenatal' lab section which lead to a lot of confusion today when I had to explain repeatedly that it's for preconception, not prenatal, testing. 

Back home, no one really does preconception testing like this - it was certainly never offered to me. Rather nice to have it done now so that I have a good baseline. 

Wednesday, 2 December 2015

Off To a Good Start

Had my first tutorial with the new group on Monday. The group has pretty diverse backgrounds, but everyone seems pretty nice. 

We're still at that point in med school where mostly everyone is still being almost artificially nice. I expect this'll start wearing off soon enough. 

With this new group, I am less nervous than I was with my first. I don't chatter as much so hopefully I will make a better impression this time around. Not that my last group actively disliked me or anything, but I do think I got off on the wrong foot and did not make the best impression of myself and I hate making a bad first impression. 

Guess we'll see how things go. 

Had first clinical skills for MF2 last night and I actually surprised myself by how much I remembered of the abdominal exam. The residents we have seem really nice. One is a PGY1 emerg and the other is a neuro resident (I think PGY1 as well.) They definitely seem more laid back than the original email exchange seemed, so I guess that just proves how important it is not to assume. 

I'm looking forward to getting to know this group and hopefully setting up some electives soon. I haven't heard back from the emerg physician I emailed but I've been told he can take a while to get back to students so I'm just going to leave it for a bit. If I don't hear back from him, I'll email one of the other contacts. 

Time to finish preparing for tomorrow's tutorial. I like that my new schedule (1-4pm instead of 5-8) means I'm home in the evenings, but I don't like that it means I don't have all of Thursday to do my prep. I have to go have blood work done in the morning so I can't even anticipate having that time. 

Still not too bad. Preparation averages about 4-5 hours per case. Sometimes we have two cases per tutorial but this week's is only one. Can't really complain, considering how intensive some of the other schools' schedules are. Mine is pretty laid back, really. Gotta love Mac. 

Sunday, 29 November 2015

Takin Advantage of Little Breaks

Thanks to the fact that I'm between MFs, I don't really have anything to do this weekend. And the next couple of weekends, I'll be cleaning (madly) because a friend of mine is coming to stay with us over the solstice. 

So I am doing nothing. Hanging out with my kids and pets. 


This is a very insistent cockatoo. When he wants to cuddle, you have no choice in the matter. 

The best part of the fact that this is more or less a very long weekend (haven't had any actual work to do since Tuesday) is that I've managed to catch up on my sleep. Haven't been sleeping well lately - health stuff causing issues - and so I finally feel refreshed. 

Considering that it looks like MF2 is going to be much more intense than MF1, I think it's for the best that I'm at least going to enter it not feeling half dead. 

Think I'm going to go drag the kids out for a walk. It's nice and cool. Perfect timing. 

Just have to get this bird to agree to go back into his cage...

Saturday, 28 November 2015

Degrees of Degrees

I don't have my BSc.

I want it.

Apparently, most of my classmates who got in out of third year are receiving or have received 3 year degrees from their home schools.

I called my school twice and then emailed and finally heard back. Apparently, they don't do this. But they can apply up to 30 credits worth of professional school coursework to the completion of a degree.

Conveniently, I only need exactly 30 credits to complete my degree requirements.

It is up to the chair, though, so I emailed her. I don't know if it will work for med school the way it does for the vet students (who usually are granted their degrees under this provision.) They have actual grades and their courses are structured rather like undergraduate courses. I don't have grades nor do I have discrete courses like they do. This might complicate things.

I can see procomp being used as equivalent to the requirement for communications and English (considering it has a writing component.) Clin skills and anatomy could easily be considered lab courses.

It'd be really cool if she agrees to this and I manage to be awarded my degree. I would totally fly down in May for convocation with my classmates. I'd be receiving my degree with my original class, which is pretty cool. And it'd look funny on my CV - BSc in 2016, MD in 2018.

But yeah, I just feel like I've left the kettle on or something. It's unfinished, and that's bothering me. I want to be able to hang a degree from my home school on my wall.

Hopefully the chair will allow that to happen.

Friday, 27 November 2015

Homework

Completely random sidenote: I just realized that Monday was ten years from the day I met my husband.

We got married pretty quickly - we'd been planning a long engagement but our son sort of accelerated things - so I often only really think about our anniversary, but it's still so weird to think it's been ten years. Geez.

Just thought I'd record that somewhere.

Anyway, MF2 is now just a couple days away. My tutorial group had a lovely goodbye supper after our last feedback session and taking up our final CAE. It's now well and truly over.

Next up is GI and Endo and I expect this is going to be a fairly easy MF for me given my previous enjoyment of endocrinology.

Things are definitely going to be different, though. While my tutor and clinical skills preceptors were all very laid back in MF1, I know that's not the case for all groups. When we were doing our mock OSCE (Objective Structured Clinical Examination - basically, being examined on our clinical skills with standardized patients) a lot of the other groups who were in the sim lab were stressing out completely. Freaking out about not knowing things, asking us about particular acronyms and so on. My group was just sitting back, chatting.

Our preceptors just kept telling us not to worry, that we knew what we were doing, etc. They were really fantastic coaches and I'm going to miss them.

The preceptors for this next MF seem to be a bit more... particilar. I already have a chapter to read in a textbook I don't have (I use a different clinical exam book but apparently we're now expected to have a copy of the one they use.) We're also being required to do 15-20 minute presentations on a topic chosen from a particular list. Mine isn't until the seventh session, so that'll be at the end of January.

It's really interesting how different the various groups are. Some tutors are very, very old school and insist that you learn things a certain way because that's how it always has been, whereas my tutor really allowed us to lead and wanted to ensure we understood concepts, not that we could regurgitate.

Going to be an interesting week, that's for sure.

Wednesday, 25 November 2015

Something Besides School!

I'm finally going to do something extracurricular. 

I've mentioned several times before that I love the interview videos that the school's put out and Mac's last year was really impressive. So I'm going to try to be part of creating this year's. 

Of course, the first meeting is right after our parent observation session at my daughter's school and just before an appointment so I can't really go to that, but I'm hoping to go to the future ones and contribute. There are a lot of talented people in my class and I'm really excited to see what everyone comes up with. 

I've gotten so much enjoyment out of these videos over the years that it's only right that I try to make something for next year's students, eh?


Sunday, 22 November 2015

MF Done

Tomorrow is my last CAE of MF1. Everyone jokingly calls MF1 "MF Fun" because it's apparently the most laid back of the five. I can see it; the last three months haven't really been taxing by any means. To be honest, I expected to be more exhausted by this point in medical school but I'm doing really well.

Of course, I'm nervous about MF 2 (or "MF Poo" as it's known since it covers the GI system) because I'll be starting with a whole new group, which means a whole new way of doing things. Guess we'll see how that goes.

I actually really don't feel ready for my CAE tomorrow The last one - cardio - wasn't so bad, but while haeme isn't more difficult by any means, it's a bit more complex. I like haeme, it's very interesting. But I'm definitely not destined to be a haematologist.

Just today, I'm going to send off an email to try to set up an emerg elective. Finally getting around to it, now that MF1 is pretty much settled.

Emerg is one of those specialties I can see myself doing, but the lack of follow-up is something I know would bother me. I want to know what happens after, how my patient is doing. I suppose that's why I think I'd enjoy emerg back home; I can do a bit of that, but also have a family practice (if I do a 2+1) so that I get a little bit of everything.

Even though I know this physician is very friendly and more than willing to take on students, I still feel awfully nervous about contacting him to ask if I can do an elective. They are very busy people and I don't want to impose, even though I do realize that the ones who offer to teach often do so because they actually enjoy teaching (at least this is what people tell us...)

Still, I hate being a bother, but I sort of have to be if I want any exposures outside of the curriculum. They do this on purpose, I realize, so that we start seeing other physicians as our teachers and, ultimately, our colleagues, but bridging the gap is a tough one. Doctors are still 'others' to me. They aren't part of my sphere; I'm still someone socialised to use ranks and titles and to be aware of where I fit, and I am not a doctor yet so it's hard to essentially ask a favour of someone I've never met.

But I'm going to do it since I reaaally want an emerg shift. And I have a whole list of other places I want to go, but for now I'll start with this.

Tuesday, 17 November 2015

Present Plotting

I've never understood why people think babies are so expensive. They aren't, particularly if you breastfeed and cloth diaper so the only ongoing expense is clothing.

Kids get more expensive the older they get. Their clothes get more expensive, particularly once they outgrow kids' sizes (we're probably only maybe 2 years away from that with our oldest) and hit that stage of ever-growing feet.

Their interests also get much more expensive. We've asked the kids to provide us a list of presents they would like for the holidays. This is my son's:

- a desktop computer with a touchscreen monitor
- Splatoon (video game)
- Snap Circuits 300 kit
- "whatever clothes or toys you think are appropriate" (that is verbatim from his list, I'm not joking.)

His interests now are in video games, computers, and little else. Expensive things. He reads things connected to the things he's interested in so books are always a possibility too, but he's not terribly big on fiction, aside from the Harry Potter books which we're reading as a family.

My five year old, well, she's fairly easy to shop for since she actually loves getting clothing. Except that she has discovered all these new stores here - clothing and otherwise - that we don't have back home and dear gods this child has expensive tastes. Her absolute favourite thing? $8 bath bombs from Lush.

She also loves video games (I swear my children do play outside!) and is now quite the little Whovian so she wants all the Doctor Who accessories she can get her hands on. There were tears at EB Games a few weeks ago because I wouldn't buy her a sonic screwdriver.

So yeah, kids are more expensive the older they get and right now, trying to decide what to buy these kids that will both please them and not break the bank is rather difficult.

We have decided to get our son a computer, though definitely not with a touchscreen monitor. We're buying components, though, so he gets the experience of assembling it himself and learning about how computers work. Thankfully, computer parts can be had for very cheap these days so it's not actually *that* expensive.

Whatever happened to the days they were more excited about the boxes?

Sunday, 15 November 2015

Approaching Time Off

Five weeks until the winter hols. I'm really excited to have time off, not least because a friend is visiting from back home.

She's from Calgary originally and, as always, has to pass through Toronto on her way back to see her family. This year, she's flying into TO a few days before she flies on to Calgary and spending the intervening days with us. She'll be arriving on the 19th.

She'll be with us over the Solstice, so we get to share our traditions with her. I'm very excited to have a real, proper visitor for once. As silly as that may seem, it's true. I'm super excited to share our holidays with someone.

Come March, we'll hopefully be able to host a few students over interview weekends so I'll get to play hostess.

MF1 is coming to a rapid close and I've now gotten my group assignment for MF2. It's a smaller group - only 7 instead of 8 - and my new tutor is the director of MF3, so I expect he's quite experienced with the PBL system.

I'm actually going to miss my group, I think. Took a while to warm up to each other, but I get along with them decently well but now it's time to go right back into that sort of awkward, getting-to-know-you phase of things. I'm not good at that part. That's one downside of changing groups with each MF, particularly for the introverts in the class.

I understand it's so that we can benefit from a broader variety of skillsets that our classmates bring to the table, but it's still awkward to need to get used to a brand new group, tutor, and clinical skills preceptors.

At least our procomp groups stay the same, so there's some continuity at least.

Just two weeks left of MF1 then I'm 20% done preclerkship. It's going quickly!

Wednesday, 11 November 2015

Remembrance and Remembering

I've posted before about the fact that I come from a military family. Remembrance Day means a lot to me, but it is not the only day each year that I remember our service members. I am choosing to use my blog today as a bit of a platform for a matter of some concern as relates to the theme of today, so please read this next bit carefully.

My father a Veteran - and while I have no contact with him, the impact of the Canadian Forces on my upbringing is undeniable - and I spent years working in the service of Canada's Veterans. I'm unable to serve because of medical reasons (I tried to join the CF years ago) but wish to do what I can to serve our people.

The support of our former and current servicemembers is extremely important to me and the reductions to the services they receive - particularly as relate to pensions and health care - have been immeasurably frustrating to see happen.

The newest minister of Veterans Affairs has promised to make some very important and meaningful changes to the services and benefits our Veterans receive. I urge those of you reading to write your MPs and urge them to ensure this promise is kept. Our current and former servicemembers in receipt of benefits are very much in need of these changes. It won't take you long, but please lend your voice.

--------------------------

Unrelated to the rest, today is a bit of a minor anniversary. Six months ago today was the last day of my old life. It was the very last day before everything changed, before I received my ticket to join the world of medicine.

My husband and I took a moment to look back over the last half year today and marveled at how much our lives have changed. We have changed a lot in this short time, our family has changed. Everything is different, the only exception being that we are more sure of where we are going than we ever have been before. It's amazing how fast the time has gone. Six months passed in the blink of an eye, and the remaining thirty months of my program will, I'm sure, flash by us just as quickly.




Sunday, 8 November 2015

Bloody Incredible

Now, it should come as no surprise that I enjoy theatre. I've not seen any of the National Theatre Live cinema events before, so today was something new and definitely something I'll be doing again.

Holy cow, Hamlet was incredible. Best ever production of it I've seen and I'd really recommend you go see it. The last of the encores is Wednesday so try to see if it's on near you. The reviews aren't so great, but quite honestly I loved it.

My husband and I are thinking of getting a sitter for an evening so we can go see Coriolanus. It's a replay of the 2013 production, but it still looks like it'd be fantastic on the big screen.

The husband and I are actually starting to make plans for the end of next year; we definitely want to take a trip for our tenth anniversary. The question is whether we bring the kids or not. If we don't, we'll have to decide whom to leave them with, and that's a lot to ask of friends. We'd rather not bring them since most of what we'd want to do would be intensely boring to a 6 and almost-10 year old. Museums and theatre and seeing the countryside and wine tastings and historical stuff that generally bores kids to tears.

There will be other times in our lives where we can take family vacations. Our tenth anniversary trip (and our first real vacation ever, to be honest) probably is not one of those times.

Besides, we are going to be going home around the time of our actual anniversary. It's just that going home isn't a vacation, it's a necessity. I'm going to try to set up a post-MF4 elective there and then go on ahead for a few weeks before my family joins me. I'll likely stay with friends and then we'll get a cottage for the real vacation part of it all.

Since we're well into November now, it's really time to start thinking about those block electives. It's generally easiest to set them up in the Mac area since schools often don't let preclerks do visiting electives, so I'm probably going to end up doing most of my elective time here, but if I can manage it, I'll probably split the 7 weeks of elective time into 3 weeks here, 2 in Ottawa, and 2 back home. Ottawa and Hamilton are probably the only areas outside of the Maritimes I'd really consider for residency.

I was thinking of trying to set up an international elective, but I doubt it'll be possible.

Lots to think about, anyway. 

Wednesday, 4 November 2015

Time is Flying a Little Too Swiftly

It's November and I had a mini mental freakout over the fact.

Clerkship starts one year from this month.

My program finishes two years and six months from today. May 4, 2018.

I keep having these moments, these flashes of "who on Earth thought it was a good idea to let me become a doctor?" which I'm sure most of my classmates experience too.

There is one thing I am absolutely certain about at this point, and only one thing: I will manage to screw up along the way.

That thought is terrifying. While I realized that, as a med student, there are checks and balances in place to help ensure none of my mistakes will actually hurt people... those training wheels come off eventually. A few years down the road, sure (4.5 years is not that long!) but still.

The rising panic is never so bad that it prevents me from doing things, and I'm able to shove it right back into its box when necessary, but it's always there, peeking out of the cracks to see if I've gotten too confident and need to be brought back to Earth.

Today, I had one of those days where I freaked out a little and needed to chill out. So I'm in my office, studying haematology, sipping wine and listening to Debussy. I'm going to see Hamlet on the weekend (National Theatre Live encore at the cinema, not at an actual theatre) by myself, just to have some time to come back to myself so I can re-focus. I can't let these moments get away from me. That way madness lies*.



[*Yes, I know that's King Lear, not Hamlet. Humour me.]


Monday, 2 November 2015

Med School is an Intimate Sort of thing

In medical school, you get to know your classmates really well.

You perform physical exams on them, you use each other to practice clinical skills, and you chat about your own health issues and experiences with health care.

I expect there's a number of skills we won't be practicing on each other (use your imagination) but for these basic physical exams we're learning, so far we have used each other as guinea pigs. We only have so much SP (standardized/simulated patient) time, since the school has to pay them and budgeting is a necessity.

Clinical skills remains my favourite part of classes. It's where you really start feeling like an actual doctor. The classroom stuff is good too, particularly the way we do tutorials where we fire around ideas and look at the underlying physiology of the patient's symptoms and what they tell us about the overall clinical picture.

But it feels more doctorly to be in a clinic. using a stethoscope and your wits.

Now that we're into November, I've got a good handle on the swing of med school, and my last week of family med placement is next week, I'm about to start trying to set up some horizontal electives. L&D is pretty much 'no' because that's full for the foreseeable future and, well, I've delivered two kids myself so a lot of the mystery is gone from that for me. I'm going to try to book an emerg elective in the nearish future since I really, reaaally want some emerg exposure given that it's one of the few specialties I think might compete with my interest in FM. In all likelihood, I can see myself doing FM with a +1 emerg, so I think some early exposure to emerg is important.

I'm not so big on surgical anything, so I'm not in any rush to book electives in surgery, but I'm going to try to sort one out in the next few months just to be sure that I dislike surgery as much as I think I will.

Probably going to see about setting up a radiology horizontal, if I can. I don't imagine radiology is where I'll end up, but I"m trying to keep an open mind and I do have a thing for medical physics, so who knows. That's the purpose of these horizontals, anyway. Try things out, learn about what you actually like when you see it in practice.

So, first step is probably going to be to try to get emerg set up, and then maybe radiology, IM geriatrics, most likely, and then a rural horizontal somewhere.

Things are about to get a whole lot more fun. :)

Friday, 30 October 2015

Board... Bard

I was completely taken with the idea to watch Shakespeare this evening, so at the moment my husband and I are watching Hamlet - the 2009 RSC television version with Patrick Stewart and David Tennant. It was either this or the 2012 Joss Whedon take on Much Ado About Nothing, but given that it's the night before Hallowe'en, a tragedy seemed more appropriate.

It has been a very long time since I've seen live theatre, and I very much want to while we're living here. While there is some at home, there's not often the classics, and not with the same sort of production budgets as you see in larger centres (naturally.)

Lately I've been spending time with old friends; the poems, plays, and novels that saw me through most of my life, which is what brings this all to mind. I'm feeling.. artsy.

This time of year always leaves me rather pensive even though I love it. I think it mostly has to do with the fact that I know the coming winter will be hard - it always is - and so I am trying to get most of my thinking out of the way before the snow falls. The last year, since I really went through my usual excessively introspective phase, has been a hard one, so I think this year it is even more necessary than ever to dredge up my ghosts and put them to rest.

It also so happens that tomorrow is the last day of my religious year, so it's supposed to be a time of reflecting on our previous year and purging ourselves of things that will drag us down. It only makes sense that my mind would go back to the changes over the last year and finally address them.

It also brings to mind the fact that there are only 25 hours left in October, and November is going to mess with my mind a bit because it's a year from then that I start clerkship. School is going fantastically well; my evaluations are all very good (we don't have marks, I can't post any like I did during undergrad) so it's hard to feel particularly bad about anything.

I'm just think-y and brooding a bit.

Which is why it's a good night for Shakespeare.

Also, we made a TARDIS pumpkin and it's going on our doorstep, along with the teal pumpkin (which is something you should look into if you are giving out treats this year!) This is completely unrelated to the rest of my post, except perhaps the fact that we're watching something with David Tennant in it.

I am absurdly proud of this somewhat amateur attempt. 



Thursday, 29 October 2015

Five!

Today was my little girl's fifth birthday.

She has interesting tastes. Actual Venetian mask, by the way. I love Pier 1. 


When I started school, she wasn't even two. I've been a student for more than 60% of her life, and by the time I finish training (which includes residency) I will have been a student for more than 80% of her entire life.

It's really hard to believe that she's already five. By the time my first child turned five, we had a fourteen month old toddler too, so things are very different this time around.

She's grown into quite a vibrant child, though her energy gets the best of her some days. She has a hard time focusing, and we're just sort of waiting at this point to see if some structured school time and a bit of maturity help that, or if it seems like we need to seek any sort of assessment. For right now, we're taking a watchful waiting approach, and we're stepping up the enrichment at home.

But today, she was just five. A happy, bouncy, silly little five year old who got a T rex, a bunch of books, craft supplies, and a Batman cake for her birthday.

Wrapping her T rex was fun. I'm pretty sure she knew she was getting it, so I decided to wrap it as obviously as I could.
I am very excited to see where age 5 takes her. I love watching my kids grow up, even if I do get a bit nostalgic by times. They are growing into such fantastic people that I can't help but enjoy being along for the ride.

Monday, 26 October 2015

Well, that sucked.

I just had my annual migraine. Ever since I was pregnant with my son, I've had roughly one real migraine per year, and I consider myself fortunate that that's it. I know people who get them regularly and I have absolutely no idea how they function.

The thing about migraines is that they're sort of like the flu. People use the term almost flippantly unless they've actually experienced the real thing. Someone will say "Oh, I've got a migraine" when they just have a tension headache, or "I have the flu" when they're at work with a bad cold.

Hint: if you're still able to function relatively normally, it's probably not a migraine or actual influenza. If you've ever had an actual migraine or real influenza, you know this.

I was up late (early, really) since I couldn't sleep, which isn't that uncommon. My sleep schedule is odd.

By just after 2 this morning, my head was splitting open. At 6:30am, just as my husband was getting up, I emailed my tutor and advised him I wouldn't be at tutorial tonight. An actual migraine feels a bit like your brain is attempting to liquefy itself in an olive press, at least that's how I've always experienced them. I get nauseated and I've actually been sick from them before, though fortunately I wasn't last night because that makes it a lot worse.

Acetaminophen + caffeine (well, tea, which may actually not help since tannins can supposedly trigger migraines, but it's not like I have caffeine tablets hanging around and I was sort of desperate) which didn't work. Neither did an NSAID, so I just drank a bunch of water in case I was dehydrated which can make it worse.

I fell asleep sometime around 6:30 - it was pain, not caffeine keeping me up - after I emailed my tutor, and woke up just after noon.

Migraines leave you with a sort of hangover; this residual mental and physical weakness that can make you ache for days. My arms actually feel shaky, which is the weirdest part because they didn't hurt when the migraine was in full swing. My head still aches a bit, but it's just a normal headache, nothing worse. Can't really focus much at the moment.

My wonderful husband made pork roast for supper and even though I am really hungry, the smell of it is putting me off. Stupid migraines.

Sunday, 25 October 2015

The Little Sacrifices

My husband and kids are going to a movie this evening. Hotel Transylvania 2. The kids loved the first film and since they both had a really good week at school, we were going to all go out as a family for a treat.

But I have so much to do. I still have about 4 more hours of lecture review that I want to do today. I have to space it out a bit and take frequent breaks to ensure the material is sinking in. Just watching lectures one after another is a waste of time; I need to ensure I'm actually actively reviewing the material. I'm not taking notes this time around, instead focusing more on the speaker.

The fact that I have to take this staggered approach to my review means I can't really lose three hours of the day. I have most of tomorrow off, since tutorial isn't until 5pm for me, but I'll be using that to prep for tutorial, which itself takes up most of the evening. I just don't have much time to prepare for this CAE before Wednesday morning.

I have Tuesday afternoon off, and I'll probably have most of the evening since our clinical skills sessions don't usually last the entire three hours, but still, I don't like reviewing the last day before a test, even if the CAE is more "test" than test.

My group members and our residents were kind enough to agree to schedule clinical skills for Tuesday this week, instead of our usual Wednesday, because my daughter's birthday is Wednesday. It was really kind of them because a lot of students probably would want that evening to study instead of do clin skills, but they were nice enough to agree to the Tuesday time for my benefit because my tutorial members are pretty cool people.

I am, of course, having a very slight panic at the fact that my youngest, my little baby girl, will be five years old in three days. I still think of her as being this big:
She was a year and a half old here. And yes, she's listening to her dad's heart with a stethoscope. Well, trying to since she forgot to put the earpieces in. She has been saying since she was two that she wants to be a doctor, and I really can see it happening someday. 
But she's not that little bitty thing anymore. She's going to be five years old. My feisty, fiery, rough-and-tumble daughter. The kid in the princess dress running around picking up bugs to examine them.

I hate that I'm missing the movie this afternoon, but it's just one of those sacrifices I need to make to ensure our future. At least this time around, I won't miss her birthday. Hopefully I won' t in the future, but that's something over which I have no control.

Saturday, 24 October 2015

Cardio Closing

We just finished our last week of our cardiology block. That's four weeks resp and four weeks cardio, done, and then five weeks haeme left to round out Medical Foundations 1, the first major block of my medical education.

Preclerkship at Mac is broken down into five blocks. MF1 is, basically, oxygen supply and demand. Resp, cardio, and haeme (yes, I use the correct spelling of haeme. It annoys me slightly that most of my educational materials do not.)

MF 2, which starts November 30th for us, is metabolism. Nutrition, gastro, endo. It runs for a total of 9 weeks, though we get a 2 week break at the end of December.

MF 3, also 9 weeks, starts on February 15th of next year. Renal, repro, and genetics. That takes us through to mid-April, at which point the ten weeks of MF 4 (immunology and oncology) starts. That one wraps up late June and then we have eight weeks, during which we have to complete 7 weeks of block electives. We get one week of vacation during that time. These are called our "Post MF4 electives."

After the post MF4s, we're back for MF 5, 13 weeks of msk, neuro, and psych.

Then we have a week's orientation before clerkship starts on November 21, 2016. That is just over a year away.

I'm literally two months into medical school, and clerkship is just over a year away.

That's terrifying.

A year goes by so damn fast these days that I can practically hear the 'whoosh' of it. I'm going to be a clerk before I know it.

I mentioned in a small group session last week that by the time the next election rolls around, we're going to be PGY2s (second year residents, for those unfamiliar with the term.) Sure, we'll only be a few months into our second year, but still. By the time we next go to the polls for a federal election, in the fall of 2019, my classmates and I will have already completed more than a year of our residencies. I will be less than a year away from entering practice, if I don't do a +1.

It is sufficient enough to speed up my heart rate a little when I start thinking about it.

At the moment, I need to focus on reading ECGs. not panicking about my future.

But the panic will be back, I'm sure. MF1 will be gone before I know it, and the rest will follow it far too quickly into the past.


Thursday, 22 October 2015

The Best Part of Having Your Own Office

I seriously love my office. It is my peaceful little oasis in the house, and it's a space that is all mine, so it is not so much decorated as a collection of things I enjoy. Lots of books. Plus my instruments, my Kirby (yes, the video game character), my various bits and bobs of art supplies, and whatnot. It's a room for me to work, but also to take time to relax and centre myself.

The absolute best decision I made when we were finishing the office was the decision to put a couch in it.

The couch we found is actually a sectional which pulls out to a queen sized bed. Got a fantastic deal ($250! For a sectional!) and it's in really good shape. It is also quite possibly one of the most comfortable couches I have ever had the pleasure to own. It has the one drawback of being ugly as sin, but I don't care. It's comfortable and I love it.

Beloved Family Dog agrees. The mammalian pets are't usually allowed in here, but she seemed sad today so I let her as a treat. 


Because I only have a tiny, high-up window, there's very little outside light coming in so even during the day, it's pretty dark in here. This means my office is the best place in the house to take a nap, which is a hobby of mine. Can I call napping a hobby? I'm awfully good at it.

Funny thing is that I've always had trouble falling asleep at night, ever since I was a kid. My mind goes berserk and I spend hours calculating sums or re-reading a book in my head or some such nonsense because I can't shut it off long enough for me to fall asleep.

But at 4pm? Five minutes and I'm dead to the world.

I have a feeling this will come in handy in the coming years of erratic sleep schedules.

Maybe I should practice more. Make sure I'm really good at grabbing a bit of sleep whenever I can, just to be sure I'm ready to go come residency.

Too bad I have to leave for tutorial in an hour.



Wednesday, 21 October 2015

Ugh, parking

So, I sort of don't go to lectures at all anymore. Well, I go to mandatory ones. 

I live about 10-15 minutes away from campus. It's rather convenient to be so close, though that 15 minute drive becomes a 30 minute drive in the morning. Problem is, the only parking lot I could get a pass at was the M lot, which is over a kilometre from campus. There's a shuttle, but it drops me off on the other side of campus from the building where all of my classes are.

It's not that I mind a bit of a walk, it's rather refreshing, but it means that in the mornings, when we have lecture (LGS) I have to leave home over an hour before it's scheduled to start to get there on time, and sometimes I still don't because the traffic can be so variable. It is REALLY annoying.

I used to only have to leave home 20 minutes before I needed to be in class and I lived further away. 

So I don't go to campus unless it's mandatory because it's frankly a waste of my time to spend an hour in transit when I could just stay home and watch the LGS online in that time. I have been mildly lazy about watching the LGSes online, but I'm not falling behind material-wise, so there's that. 

I'm basically telecommuting to med school. This does mean that occasionally I go to campus only once in a week, for ProComp on Tuesday. That will be the case this week, because both my tutorials and my clinical skills sessions are at the hospital closest to my house. I drive several of my tutorial group members to the hospital whenever we need to be there, so I end up going to campus anyway, but at least I don't have to park.

Pretty excited for clinical skills tonight, though. We're doing cardiac exams in the hospital, on real patients. It's a bit nerve-wracking to ask to learn on real patients when they're already in the hospital which means they're obviously not having a great go of things, so I don't want to bother them, but they have all been fantastically kind about participating in our learning.

I've actually not seen a patient yet refuse to have a med student. It's really quite incredible. But I suppose with this being a med school city, people sort of expect it. 

Works for me, anyway.

Monday, 19 October 2015

GO VOTE!

Now, it should be no secret that my political views lean progressive, so it should be no surprise that I am very excited about today's election because tomorrow, Stephen Harper damn well better not be prime minister.

So after my kids' doctor's appointment this morning, I brought them with me to the polling station. Since I don't yet have an Ontario driver's license (long story as to why that hasn't happened yet) I had to use my Mac student ID and bring up my phone ebill on my mobile.

The list of ID you can use is here. You do NOT have to print bills or statements that you use for ID - they can be shown on a mobile device. The people at my poll told me I was the first one they'd seen do it, but know it is an option.

Your employer is legally required to give you 3 consecutive hours off during the day, for which you must be paid, if you are working during the polling hours.

If you are an eligible voter in this election, I urge you to GO VOTE!


Friday, 16 October 2015

Emergence

There's something very special about working with parrots.

Unlike dogs and cats, parrots are not domesticated. They can be tame, but ultimately the species kept in captivity are unchanged from their wild cousins. They are still wild animals. Pet parrots become accustomed to humans throughout their lives, but they haven't been bred for millennia to trust and want to associate with humans, as is the case for dogs.

Over the last few weeks, we've seen our galah learn to play with toys. He's figured out how to boss the cats around. He's bonding to my husband and learning to tolerate me. Our son has even made some inroads with him.

Today, we brought him to be groomed and while he screeched his head off while it was being done, he calmed almost immediately afterwards and chatted with people while we shopped at the adjoining store.

He looks to us for comfort now. Our voices can calm him. He's learning to trust, and he's getting better.

Cockatoos are very demanding birds. They require a ton of socialization and they need to be fed well, housed well, and constantly entertained or they start to mutilate themselves. It can be a very difficult behaviour to address once it starts. But with just a few weeks of constant attention, good food, a huge cage, and lots of toys, he's coming out of his shell, and he's leaving his new feathers alone. His belly and neck have a bunch of pinfeathers that have come in over the last week, and he's not touched them yet. We're hopeful.

He hasn't bonded with me like he has with my husband. It will probably take a long time before I'm able to handle him the same way, and I'm okay with that.

I know how important it is to be slow, and to meet someone where they are when you are trying to build a relatioship. Particularly with somebody (somebirdy?) who has had difficulty in the past. I know the value of patience, of calmness, of not taking rejection personally, of not rising to attacks.

As silly as it may sound, I think some of the skills I've learned in dealing with parrots - these beautiful, wild, unpredictable beings - will come in handy when dealing with people. So far, every patient I have seen has been very kind and very approachable. That will certainly not be the case, particularly once I do an emerg elective, I'm sure.


Gray's and Dreaming about a Doctor's Office

I have a bit of a thing for nice books and writing instruments. I have a hand-tooled, leather bound, sewn-spine journal made with handmade paper, and I use dip pens and bottled ink to write in it. It feels almost luxurious to write in something like that. I'd certainly recommend it if you ever want to feel like a scribe from the middle ages.

One of my dreams is to have a gorgeous library in my home. Rich woods; studded leather chairs; occasional tables just large enough for a pot of tea. Like what you'd imagine of a scholar's office from one of the ancient universities.

Naturally, this office will have walls lined with built in bookshelves, and these shelves will be lined with beautiful books. Not the gaudy, glossy, brightly coloured texts of today, but stately references and magnificent gold-lettered, leather or cloth bound books on all the subjects I love; physics and medicine and literature and drama. I want beautiful copies of the works of my favourite authors.

And along the shelves I'll have dotted little areas to display the antique medical curiosities I have always wanted to collect. A replica of van Leeuwenhoek's microscope; old patent medicine bottles; military med kits from WWI; devices and documents and all sorts of things which can tell small parts of the story of medicine.

I've dreamed of this library of mine since I was a child, and I very much intend to make it real someday. My husband knows how I feel about beautiful books, and I told him years ago that I wanted a leather bound copy of Gray's Anatomy once I got into medical school. I figured he'd forgotten long ago.

Turns out, he remembered.


He bought it as a gift to give me after the white coat ceremony, but it didn't arrive until today.

That book will hold pride of place in my library, when I finally manage to build that sanctuary I've dreamed of.

Wednesday, 14 October 2015

Didn't trip!

Got my white coat yesterday and, to my amazement, I did not trip whilst traversing the stage even though I made the incredibly stupid decision to wear heels that I am uncomfortable in.

The ceremony was fantastic. They introduced us by name, degree(s), and previous school(s.) My classmates are certainly diverse. The speakers were lovely and it really solidified how glad I am to be there.

I got a lovely note from a physician who graduated from McMaster in 1978. I'm not sure it's appropriate to copy it here in its entirety, but here's a few excerpts.

Welcome to life long learning in medical sciences.

Medicine opens up a whole new world of adventure, curiosity, joy, and fun. 

Often it is not what you know but how to relate to people, so please take time to talk with your patients and forget your computers and phones for a few minutes.

It's on both sides of the notepaper that Mac provides so I'm going to make a high quality copy of the back and then frame it with the actual note and the copy side by side so the whole thing is visible.

I really feel like a medical student now. It's not the white coat that did it, but the last seven weeks of learning and the marked change in how I interact with physicians and classmates. I realized I'm really building that clinical decision-making framework and it's slowly building on the knowledge I brought with me and that will grow in leaps and bounds over the coming years and throughout the rest of my career.

It's been over twenty years since I learned what the white coat means, and twenty years I've wanted one of my own. Now that I actually have one, it's hanging in my closet and I'm unlikely to wear it often. It's my mind, not my wardrobe, that will make me a doctor.

Tuesday, 13 October 2015

Extra, Extra

There are a lot of things medical students can do to fill up their extra hours before we begin the most intensive part of our educations.

There are interest groups, various levels of student government, event planning, student organizations of all sorts, medical advocacy, community groups we can become involved with, optional talks and lectures, conferences on science and medicine. At Mac, we also have horizontals, which are optional, the musical, and eventually the interview weekend video. We'll be able to volunteer for interview weekends.

On top of all of that, there's the usual sorts of things students can do in their free time; intramural sports, community volunteering, groups, research, political activism, and so on. 

Frankly, there's a lot we can do. The interest groups in particular are a big thing for a lot of students. 

I do very, very little in the way of organized activities outside of school. There's all sorts of things I'd certainly be interested in participating in, like the musical, horizontals, several clubs, and IGs, but I have learned the value of saying 'no.' Being able to say no is how I've managed to retain my sanity so far. 

My evenings when I don't have clin skills or tutorial are spent at home, with my family. We eat supper together. Unless I have a ton to do for the next day, I try to help with the bedtime routine. 

Weekends are relaxing and catching up, doing things together. Spending time as a family.

There are so many things I could fill up that time with, but nothing as important as my husband and kids. Time spent at home isn't wasted, it is cherished. 

The next few years are going to cost them so much time with me. I will be around less and less as my education ramps up. It's already starting, in that I'm home only four evenings a week whereas before I tried to ensure I was home for supper every night. Some days, I only see the kids a couple of hours.

I can't bring myself to give up on the sometimes very few hours I have with them just to do something optional. 

Beyond that, I find I need a lot of 'me' time of late. Time to just write, or knit, or do some calligraphy. Time to be something other than a wife, mother, and medical student. Filling up my every waking hour with commitments would just exhaust me. 

While I understand med students are typically the so-called "type A" sorts, I can't help but worry that some of my peers, who seem to take on a little bit of everything with gusto, are barreling towards burn out at an alarming rate.

Perhaps this is why Mac does so much about self-care. It does matter. Time has taught me how far I can push myself, and how I shouldn't be forcing myself to that limit all the time. 


Monday, 12 October 2015

Little Ceremonies

There's something ritualistic about making a pot of tea. The order and almost automaticity of the steps remains constant. It's my favourite morning ritual. Fantastic way to wake up. 

At the moment, I'm having cereal and tea for lunch instead of breakfast because we're having an utterly lazy day. The kids have been munching on leftovers. There are a lot of leftovers. That was sort of the plan. 

I cooked. I cooked on Saturday and from when I woke up until minutes before we ate at 2pm yesterday. 

It was amazing. The stuffing was perfect, the gravy was perfect. The vegetables all done just right. It was the first time I did a full holiday turkey dinner all on my own (I've made all the components at sometime or another, obviously) since they were always at my parents' house and I usually just helped cook. This time I did it all start to finish, and it was perfect. We even had wine with our holiday meal, something that is a rare thing in our house. But the presence of a bottle of red or a bottle of rosé (my husband's and my preferences, respectively) in the fridge has become increasingly common, so we had it at the table. Literally the first time the kids have seen us drink alcohol, so it was a point of discussion. 

Next special occasion is actually tomorrow. My white coat ceremony, my official welcome to the profession of medicine, something I've been looking forward to for over twenty years. My husband and kids are coming, and I talked to the other students with kids and they are bringing theirs so they won't seem out of place at all. 

I am ridiculously excited for this, you have no idea. It's a big, big milestone in my life and even though I know it's purely symbolic, symbols can be very important. This one is. 

And I'll have the three most important people in my life in that audience to see it happen. What more could I ask?

Still need to work on my son's place-setting skills. 




Saturday, 10 October 2015

Thanksbaking

We're doing our Thanksgiving dinner tomorrow (at a proper dinner time, which is midday. The late day meal is supper) so I've been doing the baking today. I want Monday off which is why we're doing it on Sunday. 

Started out roasting pumpkins for pie:
This is pan #2. We processed six pumpkins. 

After we did the home grown pumpkins last year, I don't think I can ever go back to canned pumpkin. It's just not the same. 

The pie is currently in the oven, and there's ten cups of purée in the freezer plus another cup and a half in the fridge for later use. Apple pumpkin muffins are *amazing* and I want to make a batch to take to my tutorial group. 

I also made some bread. Clover rolls, pan rolls, and a loaf.

I'm still debating whether I'll make a lemon pie too, which is something we usually have at thanksgiving. I've already made the crust, I just need to roll it out and whip up the filling. But I might use the crust to make apple turnovers instead. Decisions, decisions. I'll be whipping up the cranberry sauce shortly so it can set overnight in the fridge. 

We're doing a proper, full maritime thanksgiving. 

Turkey, potatoes, sweet potatoes, cranberry sauce, turnip, carrots, beans, pickles, beets, and mustard pickles. Buns and bread and pie and gravy. Maybe throw a pan of biscuit in tomorrow to have with the gravy. 

This is our first Thanksgiving as just the four of us and I want it to be a special one to be the foundation of many lovely memories. 

The kids are excited for the food. I hope that in the coming years, we'll have local friends to invite over. People to welcome into our home, to share a meal with. There's old magic, of a sort, in breaking bread together, and Thanksgiving is a particularly special meal to share. 

We have so much to be thankful for this year, so very much. What a meal this will be to celebrate all that we have gained and all that we have to look forward to in the years ahead. 


Yes, my kitchen does smell amazing right now. 



Thursday, 8 October 2015

Red Stethoscope Diaries

So, my family med experience supervisor is a fantastic teacher. I really like her, and I think this experience is going to be incredibly beneficial. It's definitely immersive. 

Today was day two in the doctor's office and I got to see patients on my own. Obviously just to do preliminary history taking and exam and my supervisor came in afterwards, but it was really fantastic to get the chance to see them and figure out what questions to ask and to manage to do so without being awkward at all. I can tell that today even compared to yesterday, my confidence is growing.

As I expected, I'm actually a lot more comfortable in a clinical setting than even a simulated encounter. Meeting with real patients who have real concerns really makes the "I'm going to be a doctor" feeling sink in. 

I even got to use my own stethoscope today and record notes in patients' charts. The nurse at the office has offered to teach me to do injections, which she has apparently done with previous med students. 

Next week I'll be back in the clinic with my supervisor in the morning and I'll be spending a few hours in the afternoon with the pharmacist who does diabetes monitoring/management which I think is going to be really valuable experience.

Honestly, I'm having a blast right now. I think I can take on some electives so I made some contacts at the elective fair yesterday. I'm hoping to be able to do a couple weeks back home next summer and the lovely woman who helps organize rural placements through the established program here provided me contact information to try to set that up. 

I'm planning to reach out to see about some horizontals in surgery, IM, Obs/Gyn (reproductive endocrinology, actually. The L&D electives are pretty much all full and, well, I've delivered two kids - I know how it goes)  and palliative. I definitely need to try to set up an emerg elective ASAP since I really want that exposure too, but I don't want to overwhelm myself.

As it is, I'm am loving the clinical exposure and I can't wait for the next time I can see a patient. I know this is early med student enthusiasm and will fade with time, but I'm going to enjoy it for now 

With my shiny red stethoscope from home. 

Wednesday, 7 October 2015

Family Medicine

I spent a few hours this morning shadowing a family physician. It was literally only my second exposure to real patients, so I'm not diving into history taking and physical exams just yet, but that will start before long.

I'm back at her office tomorrow afternoon.

It went really well. I got to see several patients, all with very different complaints, and we talked a bit about the organizational structure of her office and family health team. It it quite different than how things are handled back home, so it's really interesting to see how it all works together.

The system her group uses really appealed to me - it seemed to be a rational, well-thought-out system built around patient needs while still taking physician lifestyle into account, and it just seemed overall very rational. Which, of course, makes me realize why it isn't done back home - rationally organized health care delivery isn't really a strong point for the province. It's not really the doctors' faults, just that the province doesn't really seem to make it feasible for physicians to build those sorts of networks.

Fortunately, my family medicine experience supervisor is experienced at it and she's really an excellent example of a family doctor. She's been taking her time and explaining things clearly. She seems to have a really amazing relationship with her patients and I can tell there's a lot of trust there. The office staff is absolutely wonderful as well.

I'm really looking forward to spending the six weeks in her office and I'm really glad that Mac sets us up like this right away. I've known since I was a very young child that I wanted to be a family doctor and everything I'm seeing so far is confirming that all over again.

I'm probably going to start setting up some horizontals in other areas of medicine in the next few weeks. The month or so of an somewhat relaxed schedule with lots of wiggle room is coming to a close as my calendar now fills up with clinical time and electives.

Feels like med school is really getting rolling now.


Tuesday, 6 October 2015

Real People

I'm five weeks and two days into med school classes and today I got to see real patients for the first time. 

My clinical skills group went to the hospital where our instructors (residents) were working and we saw some of their patients. 

I was surprised by how willing people were to have us see them. They were very welcoming and seemed very happy to take part in our learning. It was really a fantastic experience and I'm excited about more clinical encounters. Tonight, being my very first time seeing patients, was a bit awkward, but I think the time with standardized patients helped tone it down a bit.

My family medicine placement starts tomorrow, just a bit away from my house actually. I'll be there from 9-12. My supervisor just got back to me this evening so it's a bit short notice, but I'm excited. I'll be back there Thursday afternoon too. I'll probably spend around 6 hours in the clinic this week on top of the nearly 3 we were in the hospital today which is pretty fantastic clinical exposure for just over a month into medical school. 

At the moment, I'm coming up with some goals for the family med placement. I have a form my supervisor will need to fill out at the end of it, but I'm going to provide her a copy tomorrow for her to refer to so she knows what I'm going to be evaluated on. 

It's really quite fantastic that I'm only into October and I'm already learning clinical medicine in a clinical setting. It's not all books and blackboards, but hands on with patients, learning medicine the way it will be practiced.

After this evening's time in the hospital, I'm just overall left with a sense of immense gratitude to the patients who agreed to participate in our learning. They are under no obligation to do so, and they don't get anything from it (besides our gratitude) so it's really quite amazing that they are willing to help us when they are at a potentially difficult time in their lives. 

And tomorrow morning I get to meet even more patients. 

The "holy cow, I'm really going to be a doctor" is sinking in. 


Saturday, 3 October 2015

Once upon a midnight dreary..

While I pondered, weak and weary,
I sat and sipped on French rosé and and added to my blog once more.
(My apologies to Poe)

The only word I can really think of to describe today is dreary, which is why that popped into my head.

It was cold and wet. October has blown in with all the grace of a mannerless dog, tromping through the yard and leaving grisâtre autumn in its wake.

I rather like the colder weather. When it's crisp and the air is clearer. Autumn has always been my favourite time of year. But today was just a misery. Not even the sort of rain I enjoy. So we stayed in, and did nothing productive.

Thursday was the due date for this year's OMSAS applications. I'm very excited to see how the process goes. Even though I'm not in the thick of the application mess anymore, it is still exciting to see people filled with nerves and hope and anticipation. Many of these are my future colleagues.

I was talking to my husband about the interview period next year and we've agreed that we'll take someone overnight for each interview day. A member of the class of 2017 was kind enough to do that for me, and I said at the time I'd pay it forward and I meant it. Now that's just a few months ahead and I'm super excited to play hostess.

I'm reflecting a bit on how much the last year has changed things for our family. Life is, in very many ways, so much brighter and more promising than it was a year ago. It doesn't feel like we're stuck on a treadmill anymore.

The kids are thriving (though my daughter is picking up some terrible habits at school, which we are working to curtail.) My husband doesn't have a job yet, which is casting a bit of a pall on things, but he's trying very hard to find something. I am absolutely loving medical school, aside from a couple hiccups along the way. We have a lovely home, even if it isn't in the country. Neighbours are pretty decent.

It's not perfect, not by any means, but it's closer than we've ever been, and we've got a pretty bright future ahead.

When I clicked Submit on the OMSAS app last year, this is what I had hoped for, and I cannot possibly say how thrilled I am that things are working out.

Tonight, I'm finding myself thankful for everything we have achieved. Some challenges lay ahead, but what would life be without something to work through?

Wednesday, 30 September 2015

Supported

It's no secret that my home province is aching for doctors.

I don't generally mention the Island by name here because I don't want my blog to end up tied up in the tourism stuff Google ends up attaching to anything mentioning the province. But it should be pretty obvious what province I've been talking about for three and a half years on here.

Today, I'm feeling distinctly warm and fuzzy about the Island, though. For reasons like this: Doctors and Dentists Welcomed to Western PEI.

The community held a meet-and-greet for their new doctors and dentists.

Also today, I received my med student kit, which is sponsored by the province and the medical society.



While I realize that a big part of this is that it's basically a long-term recruiting tool, it also just feels a bit like the province is putting their support behind me. Reminding me to go on and learn, but not forget where I'm from.

The fact that this stethoscope is a very specific shade of red is entirely coincidental. I knew I was going to get a stethoscope from the province since it's a fairly longstanding tradition, but I didn't know what they were going to send me or when it'd arrive. Since I wanted to make sure I'd have a stethoscope  I liked when I needed it, I ordered one during O week. The sample red was very pink-y and I didn't like it, so I ordered burgundy, though was a bit disappointed since I have a thing about having my own red stethoscope.

Last week they emailed to ask the shipping address and I found out then that they were sending me a red Cardiology III. It's actually the exact colour I wanted and has a date of 2014 on the box so I guess they may have changed the colour in the last year. Also has the logo for the Medical Society on the nameplate, so I think this is going to be my school one since no one else will have one like this.

Having the support and encouragement of my home province's medical society matters. Island med students are a very small group of people - about 50-ish of us in the whole country - and so it feels nice to realize that they think of us, and want to show their support in such a tangible way.

Thanks, PEI. See you soon.

Tuesday, 29 September 2015

Assessment

Tomorrow I have my first CAE - Concept Application Exercise. It's exactly what it sounds like.

We have to apply the concepts we've been learning to a case.

So far, my evaluations and feedback have been very good. Quite comforting, considering I'm supposed to start my family medicine experience next week. Nice to know that I'm where expected at this point in my education and am not going to seem like a blithering idiot when I meet my supervisor.

We're entering the point where we can start horizontal electives, and I think I'm probably going to wait a little bit before I start since I'm noticing that I am getting easily distracted these days. I need to keep my mind where it needs to be, and taking on a bunch of clinical electives is not the way to do that.

I'll have my family med experience, which I'm very excited about, so I'm sure that waiting a few more weeks to start horizontals (which are optional) won't hurt me academically. But burning myself out by taking on too much too soon might hurt me academically. Not that I have marks, exactly.

Have I said recently how much I love Mac's program? Super focused on self-care and our wellbeing as future health care providers. The de-emphasis on marks and examinations (in the traditional sense) helps with that.

But I notice a lot of my classmates are preparing for the CAE the way they'd prepare for a midterm in undergrad. I'm choosing not to. I want to see what I actually solidly know tomorrow, not what I can retain from review today. If I know it for the CAE but not in the clinic, then my learning wasn't any good was it?

One thing I do think I need to be careful about is that my undergrad taught me a lot of what we've learned so far. I need to be very, very careful not to let myself coast on prior knowledge. That could be dangerous.

Sunday, 27 September 2015

Initiated Wisdom (?)

Since I got into medical school, I've gotten lots of messages from applicants (current and future) asking my advice to get into medical school.

I don't mind giving it by any means, though some of it is getting a touch repetitive at this point. Probably should get around to adding tags to my posts because a lot of what I've been writing is here on this blog somewhere but with almost 740 posts (dear me I have no life) it'd be quite the undertaking.

Thing that baffles me a bit, though, is that I got into one school out of four I applied to. Specifically, I was accepted to a school that places no emphasis on extracurricular activities (what I knew was my weakness from the outset,) has no essays and bases their admissions decisions after the MMI on three very well defined criteria: the MMI score, your GPA, and your VR/CARS score.

I had a very good GPA, a very good VR score, and so I only had to do decently well on the interview to get in, so there's no saying how well I did on the interview. Anywhere from "fantastic" to "moderately well." Did I do well enough to overcome a 9 VR or a 3.6 GPA? I have absolutely no idea. Being in medical school gives me no further insight into that than a premed has.

The years before I got in were filled with somewhat obsessive collection of admissions information so yes, I do have a pretty decent handle on what someone's chances might be, insofar as they can be assessed from the sort of information premeds share. The admissions requirements change a bit each year, though. Not every school, but some schools change them a bit. I no longer have any reason to keep up on these developments, except to help premeds (who really should be looking them up themselves,) and I just don't have the sort of time to keep up that I used to.

I don't mind helping out premeds when I have time, since I was exceptionally fortunate to be helped by a number of med students and residents and I consider paying it forward to be the right thing to do. But I think what help I can offer them at this point is not terribly, well, helpful.

I don't know how well I did in my interview. I don't know how other schools assessed my (admittedly weak) ECs. I have no more insight into how to get in to U of T or Ottawa or U of A than a premed would.

So while I'm glad to help where I can, I honestly don't know how much good I'll be at this point.