New Year's Step 1 Boards Study Pack Give-A-Way!

In an effort to continue de-hoarding my house, I've decided to give away some of those big fat medical books that crowd my bookshelf. So in hopes that other medical students read my blog, I'm giving away a Step 1 Boards study pack. It includes.....

First Aid for the USMLE Step 1













First Aid Organ Systems













Kaplan USMLE  Step 1 question book












All you have to do to qualify to win is join my blog, leave a comment on this post, and tell me why YOU deserve these books. Studying for boards sucks, and if you could save some money on study material then hopefully it can relieve some of the stress!

Deadline is January 31st.

What's in Your White Coat?

The infamous white coat. That which separates doctors from the rest of the world. If you go into medicine for the sole purpose of donning this status symbol, then clearly you're in the wrong profession. Most doctors hate even wearing the thing. It's bulky, thick, uncomfortable.... it makes you sweat way more than you should and the weight of it causes neck and back aches like you wouldn't believe. So what's so special about a white coat? Well, nothing really. What's really special is what's in it.

As I was going through my bag of "doctor" stuff that I usually bring with me to work, I pulled out my white coat. It's a short one, of course, since I'm still a medical student. Real doctors get to wear the long ones. Anyways, after noticing that it was quite dingy and needed a good bleaching, I started to take everything out of the pockets. I noticed that I carry A LOT of stuff in my white coat. And because I know you're all sitting on the edge of your seat in suspense, I'll tell you what I found.

Pocket Medicine. I recently got this for Christmas. It's basically the bible for any physician doing an inpatient rotation. Need to know which drugs to give a patient in heart failure? It's in there. How about the diagnosis and treatment of Rocky Mountain spotted fever? Yep, you can find that too. Why I waited so long to finally get this is beyond me, but I'm sure I will get ample use out of it next month on rotation.

White Coat Clipboard. This thing is pure genius. It's a clipboard that folds in half and fits quite perfectly in your white coat pocket. I've seen residents and students everywhere I go with these things and decided to scour every office supply store in the state for one. Luckily, one of my best friends who is quite savvy at finding stuff on the internet found that one company actually has a monopoly on these things. A few weeks later I got a nice surprise in the mail and now I have one of my own! Perfect for taking notes on rounds.

ACLS card. In the hospital you certainly never know when you're going to hear the words "code blue" come over the intercom. That's when I go running. The only way to get good at running a code is to watch them. And on the off chance that I get to participate in resuscitating someone, it's good to have a cheat sheet of drugs and protocols for when you're brain gets overloaded. Every doctor has one of these in their pocket. Trust me.

Stethoscope. Usually it's around my neck, but occasionally it's in my white coat pocket. No brainer.

iPhone. Quite possibly one of my greatest tools. I'm sure most of you have a smartphone and, like me, completely rely on it for everything and anything. The best thing about my iphone is all the great medical apps that I have. Most importantly being Epocrates, where I can look up every single drug and dosage that there is. Also, my Medcalc which allows me to calculate any medical formula I may need. Not to mention just having internet at your fingertips. The biggest problem is, trying to not be glued to your phone. I make it a rule to never take my phone out in front of a patient and to only use it for medical stuff when I'm working.

Maxwell Quick Medical Reference. Another small pocket book of must-knows for any physician. I use it mostly to quickly check normal lab values and to see what needs to be included on admitting orders or discharge summaries.

Odds & Ends. Chapstick, mints, plenty of pens, notebook of important things I learn, Luna bar, patient list. All very important.

By now you probably think that I couldn't fit anything else in there! You'd be surprised. By the end of the day I end up with random things like alcohol swabs, gloves, masks, more pens, tons of notes, those little plastic pieces that go on the end of an otoscope..... I know it's a lot, which is why wearing the darn thing is so uncomfortable just due to the sheer weight of it all, but quite honestly I don't know what I'd do without it. If I didn't wear my white coat, I'd have to carry a backpack.... or a fanny pack, which is definitely a no-no!

For all my doctor friends out there, I'll ask you. What's in your white coat?

Happy Holidays!

Well even though I was apparently on Santa's "nice" list since I got so many amazing gifts this Christmas, I was actually pretty naughty because I haven't written much this month! But I'm sure anyone can attest that December is such a stressful month. And where I was already so busy with my residency interviews, preparing for Christmas made it that much more difficult to sit down at the computer for more than five minutes and come up with something productive to say.

In the midst of all my interviews, I had to prepare for Christmas. First order of business was to attempt Black Friday shopping for the first time. I've never done it before, but I thought since now we have a child to buy for and I don't exactly have that doctor salary yet, we should try to score some deals. I dragged my poor husband to Toys R Us Thanksgiving night. My secret plan was to wait until the store opened at 9pm, then just hop in line as the people were piling into the store. What I didn't plan for was that they only allowed so many people in at a time. So we waited. Outside. In the cold. For an hour and a half.

After all the waiting and freezing, we finally got in. "Hooray! Time to shop!" I thought. My idea of Black Friday shopping fun soon sizzled as we realized we could barely even move around the store. Not to mention, all the toys on our list weren't even on sale! We seriously paid full price for almost everything. And the only reason we did it was because we waited outside for so long that we felt stupid leaving with nothing. I guess I should have done my homework ahead of time to find out what was on sale and what wasn't. Well, I had the last laugh when I went back last week and had a bunch of the items price adjusted for their later sale price. Bwahaha.

Next on my list of must-do's this holiday season was to get Killian to take a picture with Santa. Last year worked out well. He didn't cry at all, and we got a good picture. This year was a much different story. We traveled all the way to the Burlington mall since I've heard they have the "king" of all Santa's there, and boy was he a good-looking Santa. He might as well have been Freddy Kreuger though, because as we inched closer and closer towards him, Killian clung tighter and tighter. And even though the scary fat man in the red suit offered him a candy cane, he still screamed bloody murder when I tried to sit him on his lap. No picture.

It was soon time for my parent's annual Christmas party, which is the most anticipated event of the year.  My cousin dresses up as Santa and hands presents out to every kid there. I thought it was the perfect opportunity to get a picture with Santa since he'd see all the other kids interacting with him and not freaking out. He didn't cry, but couldn't stop touching Santa's beard long enough to get a great picture. I finally gave up and decided to just enjoy the party.

Then Christmas came! This year was Killian's second Christmas. Last year was memorable because it was his first, but this year was even better because he could actually understand it a little more. My husband and I went a little overboard picking out Christmas gifts for him this year, but it was all worth it to see the excitement Killian had when saw the riding pirate ship sitting under the tree or unwrapped his Rock Star Mickey. Of course "santa" (and the grandparents) spoiled the crap out of him, but I think he just as much enjoyed being around our families and all the attention he got.

I feel so incredibly lucky right now, not because I finally got a Kitchenaid mixer, but because I have a healthy, happy family that I got to spend some extra time with this month. Then next month it's off to another rotation doing inpatient medicine. I'll be sure to have lots of stuff to blog about once I'm back in action playing doctor. Anyways, I hope all of you enjoyed your holiday, whether it's Christmas, Hanukah, or Kwanza. All that really matters is spending time with family and remembering the things in your life that make it all worth it.

Hi, my name is Maria. I want to be a resident at your program.

"Hi. My name is Maria. I'm from UNECOM. It's an osteopathic school in Maine. Yes, there's a medical school in Maine." I can't even tell you how many times I've had to say those words over the last few weeks. Residency interview season has officially kicked off. If you happen to be in a hospital this time of year and see a small group of people being herded around, all dressed in black or navy suits with a deer-in-headlight expression on their faces, then that's me and a bunch of other exhausted, freak-out med students. We're the interviewers.

Each interview is kind of like going on a mini vacation. You get put up in a swanky hotel or bed and breakfast. Well, most of the time. There was one hotel that I stayed at where I'm pretty sure I saw a hooker check into as well. You get your fair share of free meals. The night before each interview the residents either host a dinner at their house or take you out to dinner so that you can get to know them better and ask questions about resident life. It's been a really great way of hearing candidly from the residents about how they like the program and most importantly, how happy they are. What I'm finding out more and more is that the resident dinners are actually one of the most important parts of the whole interview process because these are the people you will spend the next couple years with, and it's good to see if you mesh well with them.

The interview day itself isn't much different program to program. You get up early, meet at the hospital or clinic, have a brief intro, interview, free lunch, then tour. Usually there's three or four interviews with a mixture of residents, faculty, and the program director. The best thing about interviewing for a family medicine residency is that the interviews are a lot less stressful than if you were going into a more competitive field. They're usually more of a conversation, rather than being grilled about your credentials or being pimped with medical questions. Usually I leave the interviews feeling pretty good about myself because I have to repeatedly talk about my accomplishments and what my good qualities are. And hopefully I've made a good enough impression so that the residency director, faculty, and residents all would like to work with me in the future. 

You may not think so, but going on interview after interview is quite tiring. It takes a lot out of you trying to sell yourself and being upbeat all day long. You meet so many people, who's names I can barely keep straight. You're constantly being asked questions like "Where do you see yourself 10 years from now?" or "What are your faults?" and my favorite "Do you have any questions for us?" Most people like to prepare for interviews by practicing answering questions. For me, I thought it was counterproductive to do so. I never wanted my answers to come across as rehearsed or cookie-cutter. Besides, the last decade of my life has been preparation for this. If I don't know the answer to "Why did you want to become a doctor?" by now, then I'm clearly in the wrong profession.

The thing is, even though I'm the one being interviewed, I'm actually interviewing them as well. Sure, I'm lucky to get any sort of job really, but I'll be committing the next three years to a residency program and I want to make sure it's somewhere I'll fit in, get a good teaching experience, and become the best doctor I can be. Not to mention, I have to consider what's best for my family. Is the program family-friendly? Is there good childcare in the area? Will they be flexible if I have an emergency at home? I've always said that being a doctor, as important as it is to me, is just a job. My family is my life. So I need to be somewhere that promotes that same mantra. Which is a big reason why I'm going into family practice to begin with. We're families treating families. And hopefully you find a good enough residency program where the people you work with become your family as well...... I could only be so lucky.

Full of Thanks

I hope you are all having a wonderful Thanksgiving. I spent the day with my hubby, my little man, my parents, and my cousins. We stuffed our face with turkey and then stuffed some more with some italian pastries and pumpkin pie. Just being together with my family after such a long busy month on rotation is the greatest blessing I could have. And as always, this holiday always reminds me of the things I'm grateful for in life. I thought I'd share a few....

J Crew jeans (best fit for my post-pregnancy body)
Starbucks coffee
Tripoli's pastries (which I picked up yesterday for desert)
Grey's Anatomy (the show, not the book)
Netflix
Good mascara
Red wine
Cowl neck sweaters
Christmas music on the radio more than a month before Christmas
Facebook
Stawberry frosted donuts
Dave Matthews Band
My iPhone
Passing my board exams
My amazingly smart, beautiful friends... no matter how far or near they are
My healthy, happy, snuggly little boy
My wonderful parents, who are also the best baby-sitters ever
My super supportive, loving, handsome husband who I love more and more every day
And of course, surviving four (actually five) years of medical school

What are you all thankful for?

I Will Shelter You

Yesterday I spent my evening working at a homeless shelter, tending to the medical needs of the people staying there. I really had no idea what to expect going in. I've never been to a homeless shelter and here I was going to one of the roughest ones in one of the poorest cities in the state I was in. It was a "wet shelter", meaning that it's not required to be clean to stay there. So many, if not close to all, of the occupants were under the influence of some sort of substance. I'd be lying if I said I wasn't scared going in.

There were about 30 people getting ready to bunk up for the night in a mere double wide trailer. We got there as they were serving dinner, and there was a coordinator there keeping a running list of the people who wanted to sit with the doctor to discuss any medical issues they may have. It was my job to get their vitals and interview them beforehand, finding out what their main complaint was and what actually brought them here. Most of the patients had common complaints like colds or ear infections. And since we didn't have the resources to do any real work up like get a chest x-ray or blood work, we'd just use our best judgment and give them a prescription if necessary.

There were a lot of musculoskeletal complaints, which is hard to really address in this sort of population because you have to be weary of drug-seeking. We never actually prescribe anything more than Tylenol or Ibuprofen. I actually tried to do some OMT on a woman with back pain, but given that we didn't even have a treatment table, it was quite difficult. Sadly there was also a pregnant girl who hadn't received any prenatal care. It's hard enough being pregnant, but to be homeless and alone is another thing. I felt so bad that there was nothing more I could do for her besides give her something for her nausea and write her a note to be allowed to have crackers and gingerale.

At first I thought, what could we possibly do to help these people? Here were are, a doctor, an intern, and a medical student. We're seeing these homeless, drug-abusers in a tiny little hallway of a trailer with nothing more than our stethoscopes, a blood pressure cuff, and an otoscope. Clearly they had physical and mental issues that required much more than 10 minutes with us. But I slowly started to learn that even though we certainly couldn't cure their addiction problems or find them a permanent home, just giving them a chance to talk to us, express their concerns, get them any prescriptions they need, and make them appointments at the clinic is really the best kind of health care we could give them at this time.

I got home around 10:30pm last night and was finally able to crawl into my warm bed, lay my head on my pillow, and snuggle up next to my hubby. And as exhausted as I was, I laid awake thinking of the people I met not too long ago and how they're spending the night in a cold trailer, cramped up in tiny rooms together, and not knowing what tomorrow will bring. I couldn't help but be reminded of how very blessed I am to have my family, my health, and a place to call home. I also am very thankful to be given this opportunity to be a physician and be able to do whatever I can to provide healthcare to people who truly need it.

Halloween, Medicine, & Interviews.... Oh My!

So as you've noticed, I've been quite busy lately which is why I haven't been able to blog for like three weeks. But since Killian's napping and I'm taking a break from school stuff, I figured I'd give you all an update. I've been doing another Sub-I at a potential residency program, and my schedule has just been insane. I'm working 12+ hour shifts, getting up at 5am and getting home at 8pm, which leaves little time to spend with my special guy. So all I really get to do is give him a bath, give him his milk, read him a book and put him to bed. Lots of mommy guilt going on these past few weeks. I made a comment on facebook about how it's been rough working 60 hour weeks and a fellow med student replied that it's not that bad. Well, when you have a 16 month old at home who you have to take care of on top of all the studying you need to do for the next day, it's actually quite exhausting. 

My first two weeks of the rotation I've been doing inpatient medicine (meaning, seeing patients in the hospital and not a clinic). It's been quite the transition after doing months of outpatient medicine. In a family practice clinic you treat the most common diagnosis with the most conservative treatment, but working in the hospital you have to always rule out the "worst possible" diagnosis and treat until proven otherwise. It involved ordering lots of tests and labs, managing lots of medications, and making sure the kidneys don't fail!! (If you're in medicine, you understand my lame joke). I also had a couple patients in the ICU die, which is always hard to deal with. Certainly not as hard for the residents who knew them more so that I did.

This past week I've been doing OB, which has been a welcome change. Bringing new life into the world is always exciting. Although, I haven't done OB since having a baby myself and watching my first delivery this week triggered a bit of baby-coming-out-of-the-vagina PTSD. I still can't believe that happened to me. Scary stuff! I also got to assist in a c-section, take care of post-partum moms, and examine newborn babies. It's so rewarding doing OB because I feel like having been in their position myself, I'm more capable of advising new moms with post-partum care. I'm also way more comfortable taking care of the newborns, where two years ago I barely new how to coddle one. I felt like a rock star!

On the home front, we got to celebrate Halloween (I know it was three weeks ago, but I was busy!!). Actually, it was two weeks ago because trick-or-treat was post-poned due to a freak snow storm Halloween weekend. We dressed Killian up in his cow costume, pulled him around in a wagon and made him peddle for candy. Bwahaha. And now that we've come down from our sugar-high, we're inpatiently anticipating Thanksgiving and ready to stuff ourselves full of turkey.  I love this time of year!

So now that I've filled you in, I should get back to preparing for my first residency interview on Monday. I also have to go to an applicant dinner tonight to meet and chat with all the residents at the program. I'm super anxious to get my first interview out of the way, but so excited to wear my amazing new suit! Wish me luck!! I'll keep you posted on how things go. 

M.I.A.

Sorry everyone that I've been so rudely ignoring my blog. I've been on a long and stressful rotation which includes working 12 hour shifts. What little time I do have when I get home is spent taking care of my little man and studying. Also had a bit of a health scare thrown in this past week. I'll be sure to update you soon enough. Thanks for your patience!

In the meantime, please enjoy this cartoon I found in the google-universe:

The Sniffles

A virus has infested our house. The cold virus, to be exact. Started out with the little man (who has since almost fully recovered), then my hubby, and now me. Thankfully it seems like it's quick cold since my husband's already on the mend. But me, right now, I'm in the full blown sick-mode. I called in sick too, which I rarely do, but I really hate exposing other people (especially if it's not necessary I'm there). Of course when I'm a actually a doctor, calling in sick is typically not an option. 

I have to admit, I really hate staying home sick. It's not exactly like it's a "day off". You can't do anything, you're miserable, and you feel useless (at least I do). I am not one to just sit around and be lazy. The more I have to do, the better. I'm more productive when I'm busy. So to sleep in or sit on the couch and do nothing is killing me right now. Hopefully I can kick this cold's butt and get back in action tomorrow for my last day of my rotation. Another four weeks done, and then I'm on to the next one. In the mean time I'll be slurping down some homemade soup and catching up on emails and paperwork. 

Oh yeah, I almost forgot that I need to get a flu shot!

ee i ee i oooooo

Picking a child's halloween costume is a very stressful event. Ask any mother. I seriously cannot wait until Killian is old enough to just say, "Hey mom, I wanna be a red Power Ranger." Then Power Ranger it is! But until he's old enough to actually tell me that, I am burdened with the job of deciding on which embarrassing costume to dress my child in. 

Last year he was Tigger.....

 This year we were originally going to do family-themed costumes, but I think it's a bit ridiculous how much costumes actually cost (especially since you really only wear it once). So we nixed the adult costumes and just decided to find a really great one for the little man. Now if you've ever perused the internet for toddler costumes, you'd be bombarded with cuteness. How do you chose??? Well after narrowing it down to a few favorites we decided he would be a cow. The only problem is there was about forty different cow costumes. 

Well, as you know we've found the most perfect one from Pottery Barn Kids.....

"Moooooo"

I can't wait to pull him around in his wagon and go trick-or-treating! 

Back on Track

Despite running two 5k's this summer, I have sadly been slacking in the working-out department. I've been so busy with being on clinical rotations this fall and trying to spend more time with my family, that I haven't devoted much time to fitness. Usually I go for walks on the weekends with Killian and our dog after the hubby heads to works, but that hasn't really done much for my figure. So I decided I needed to start making some changes to get back on track.

First thing I did was sign my husband and I up for another 5k, since having a goal set in mind is always my best motivator. Then I decided that if I had enough time to sit in front of the TV at all, then the least I could do was some stretching or ab exercises. Also, this week I started hitting up the gym again and seeing how I did on the treadmill. My first day I ran a mile and a half, then walked another mile and a half. Today I got to two miles, then walked a mile. I was surprised at how easy it was to start to build up my endurance, especially since I haven't run since August. I'm also going to start doing some Itsy Bitsy Yoga classes with Killian on the weekends, and some hot yoga with the hubby.

And since losing weight and getting in shape isn't all about exercise, I've also been trying to focus on what I eat a little more. In the past I've noticed that just trying to eat "healthy" hasn't always worked for me. I definitely need more structure in my diet. So my husband has been making me healthy smoothies* twice a day, which is great for me because I absolutely hate thinking about what to eat and planning meals. I wish I was more interested in cooking, but when you work 10 hour days and have a toddler to take care of, study, prepare for residency interviews, and try to squeeze in a workout....... then there really isn't any time to cook.

Ultimately my goal is to get back in bikini body shape this summer. I had these delusions of grandeur thinking that I was going to bounce back so quickly after having a baby and be able to wear all my old clothes again (yes, even my bathing suits). Well, obviously that's not always the case. But now that I'm over a year post-baby belly, I need to get my butt in gear and start making a greater effort to regain my body! Not only just to look better, but to feel better and have more energy. I'll keep you guys updated on how it goes.

*If you have any good smoothie recipes, please share!!

One Fish, Two Fish, Red Fish, Blue Fish

I had another amazing day off with my family. Since it was a cold and rainy day, we wanted to do something fun indoors. So we trekked down to Boston to the New England Aquarium. Even though Killian's still a bit young, he had a great time watching all the fish, seeing the penguins, and yelling at the sea lions. It was awesome to see how amazed he was by all the sea-life, pressed up against the glass tanks. He wasn't even afraid of the giant shark that swam by! It took everything in my power not to try to take a penguin home with me, though I'm pretty sure I wouldn't have made it very far had I tried.

Afterwards, we went out to dinner at one of my favorite restaurants, The Cheesecake Factory. And then we were on the hunt for the perfect halloween costume for Killian, which we found at Pottery Barn Kids! I'll leave you in suspense on what we picked until a later post, though. Overall, a wonderfully fun day with my boys.... couldn't ask for anything more.

Mam-o-mammogram!

I wonder why it always takes a celebrity diagnosed with some form of disease or cancer or something to bring awareness to medical issues. Yesterday news spread like wildfire that E! reporter and reality TV star Guiliana Rancic has been diagnosed with breast cancer. What's most shocking about the news is that she's only 36 years old, four years younger than the recommended age for women to even have a mammogram. Interestingly enough, it was found incidentally by mammogram that was recommended she get prior to her third IVF procedure. If her doctor had never insisted on getting a mammogram (since IVF treatment involves lots of hormones which could potentially speed up the growth of certain breast cancers), then it wouldn't have been discovered until she was 40. Who knows how much it would have grown and spread by then?

But what makes her any different from the 1 in 8 women who are diagnosed with breast cancer? Nothing really, except that she has the ability to make her diagnosis public and bring more awareness to the issue. It also once again opens up a public discussion and debate over cancer screening. Patients are more confused than ever about health screening and tests. How often to get PAP smears, at what age to get your first mammogram, should men have their PSA tested, do you really need a flu shot..... How do you know what's really necessary and what's not? And if it is necessary, when and how often do you need to be tested? Well, since I've started out talking about breast cancer, and it is breast cancer awareness month, I'll provide some information on screening guidelines per the American College of Obstetricians & Gynecologists.

If you visit the ACOG website, you can find their most recent statement and position on breast cancer screening and mammogram recommendations. They state, "Due to the high incidence of breast cancer in the US and the potential to reduce deaths from it when caught early, The American College of Obstetricians and Gynecologists (The College) today issued new breast cancer screening guidelines that recommend mammography screening be offered annually to women beginning at age 40." It goes on to say, "Although women in their 40s have a lower overall incidence of breast cancer compared with older women, the window to detect tumors before they become symptomatic is shorter, on average. The five-year survival rate is 98% for women whose breast cancer tumors are discovered at their earliest stage, before they are palpable and when they are small and confined to the breast. If women in their 40s have annual mammograms, there is a better chance of detecting and treating the cancer before it has time to spread than if they wait two years between mammograms."


Now for women with a family history of breast cancer, the rules are a bit different. You may need to start having mammograms at an earlier age. It depends on who in your family has had it and at what age. I recommend discussing this with your physician, and you can decide together at what age it's appropriate to have a mammogram, or if you need any genetic testing done to test for the breast cancer genes - BRCA1 & BRCA2. Please keep in mind though, that only 5-10% of breast cancers are hereditary. So even if you do have a family history, it doesn't necessarily mean you carry the genes. 


As a medical student, I've done a lot of family practice rotations. The best part of family practice and primary care is being able to practice preventative medicine, meaning making sure patients are up to date on their vaccines, scheduling everyone a colonoscopy once they turn 50, and encouraging women to get their mammograms. So needless to say I've had to field a lot of questions surrounding what's important for cancer screening, particularly breast cancer. And as an (almost) doctor I think it's important to be well educated on the subject and be open to making clinical decisions along with your patient, not just making them for your patient. I want my patients to feel empowered and knowledgable and know that by having their yearly mammogram, they have control over their bodies and facing cancer head on!

Here's Looking at You Kid!

Over the last four years of med school I've worked with dozens of different physicians of many different specialties, all in varying stages of their practice. As a medical student, you're the bottom of the food chain. Your opinion rarely matters and no matter how old you actually are, you're usually referred to as "kid". Now that I'm getting closer and closer to adding those two important letters at the end of my name, I'd like to think that I would be taken slightly more seriously as a medical professional. Well, that's not always the case.

A lot of the doctors I've worked with are at least a couple of generations older than me and therefore will always see me as a somewhat of a child. On the rare occasion that I made an amazing diagnosis or done a procedure near-flawlessly, did a doctor pat me on the back and treat me as his/her (almost) equal. But the problem lies in the fact that because not only do I look like I could play I high-schooler on a TV drama, but I really am kind of young- 27 to be exact. And for the same reasons my father will probably never head my advice, nor will these doctors see me as being on the same level. Which is yet another reason why I am oh-so anxious to graduate in a little over seven months (take note of the countdown on the right side of the screen).

As a medical student, I am always respectful of the physicians and other medical professionals I work with. I wish I could say that the respect is always mutual, but often it's not. I don't know if it all goes back to this idea of the learning hierarchy of medicine, where med students and interns are typically hazed by those above them. Quite honestly I think that docs do that just to make those below them feel like it's so hard to be a doctor, and "look how smart and tough I am for being where I am now." Then you have those docs who announce in a very grandiose tone, "Back in my day, medical students kept their mouth shut and stood in the corner of the room." Yeah, I got that one from the same doc who said to me while I was pregnant, "This is why women shouldn't go into medicine".

I guess my point in all this is that just because I'm a medical student and fairly younger than my superiors, doesn't mean I deserve to be treated like a teenager who needs some serious discipline. I'm a grown woman with a husband and a child of my own. I'm obviously mature and driven enough to have made it this far. And with close to eight years of schooling under my belt, I may actually have some knowledge and skills that are worth something. So when I finally get to climb from the trenches that is residency and become an attending physician, I hope to remember how I felt as a mere medical student and treat my future students with respect.... even if their white coat is a few inches shorter than mine.

A Balancing Act

I haven't been such a great blogger lately.... I could make up some excuse that I've been so busy with school and everything, but quite honestly I haven't. I've just been spending a lot of time playing with my little guy and relaxing. I finished up an amazing family practice rotation, and just started another four week rotation. All my residency applications have been sent, my boards are done, and I've scheduled all my residency interviews! Whew, what a load off my shoulders. The only thing between me and residency is rocking my interviews and entering my list for the match. I really can't believe I'm almost done. I can see the finish line!

Apple picking last year. Killian sound asleep in his sling!

This month is going to be pretty easy going. I'm only working four days a week and have some great hours. The best part is that the place I'm working at is only about 15 minutes away from my house. I get to come home for lunch and see my little guy, and I have Wednesdays off to be with my boys. So for our first official family day, we decided to go apple picking. Last year Killian was just three months old and slept the entire time we went. This year he's walking and exploring and just so much fun. He's starting to be so independent and refused to let us carry him at all, even though he kept stumbling and tripping every few steps. It was really such a great day just being with my husband and child and enjoying the fall weather.

This year he's big enough to pick his own apples!

Balancing school and being a wife and mother can be challenging at times. The thing is, you're never on an even keel. Sometimes you put a little more time and energy into one area over the other. Thankfully right now I have the luxury of being able to spend more time with my family, but just a few weeks ago I was devoting all my effort into studying for boards and working on my residency application. It's a give and take. Sometimes I don't always feel like the best mother or the best med student, but I think I do the best I can and at the end of the day I'm proud of my accomplishments.

My Doctor-Style

Being a fourth year med student is exciting because you know that in just a few short months you're going to graduate and finally be a doctor practicing medicine. At the same time it's pretty scary because you're going to soon be a doctor practicing medicine. I think I've said before that as a med student you  feel like you'll never be capable enough to take care of patients on your own, but the good part is you have all these great physicians teaching you and guiding you. And as a fourth year med student you really start building confidence and figuring out you're own style of how you want to practice.

It's interesting working with so many different docs during your years of training. Each physician does things their own way and has varying approaches to treating patients. On one hand, it's difficult adjusting to each doctor's style and how they want things done. But it's also neat because you get to pick up little tips and tricks from each doctor you work with and create a style of practicing medicine that's all your own.

For instance, some doctors can be sticklers for running on time and keep track of each visit down to the minute. If your needs require further attention, then they simply schedule you for another visit. Other doctors are more liberal with their time, which means they may let their patients chat a little longer or do a more involved exam. Unfortunately that may make them late for their other patients. My aim is to be more in the middle. I'm definitely a chatter box and love getting to know my patients beyond their diagnoses and if I have to stay a half hour later or so then that's ok by me. But I also want to be respectful of my patients time, since it's just as precious as mine.

Another huge difference I've noticed with the doctors I've worked with is how they diagnose and treat patients. Some doctors are very conservative and have more of a "watch and wait" kind of attitude, while others go the "rule out the worse possible diagnosis" route. Not that either way is really wrong or right, but I've found that being somewhere in the middle will make your job a little easier and keep your patients happy too. But in reality it all comes down to a case-by-case basis. A common cold, is just a common cold, but abdominal pain could be 50 different things.

The thing I'm probably the most excited about as a future doctor is getting to practice a style that's all my own. For now I have to conform to how each doctor I work with practices, but in less than eight months I'm on my own! And I'm so thankful to all the physicians who've taught me along the way and given me advice. I think I've learned something valuable from every single person I've worked with (including nurses, medical assistants, and secretaries) and each one has helped mold me into the doctor I am today. Now I know I still have a couple more months of learning and molding, but I can confidently tell you I won't be like this guy:

"Hi Everybody!"

 *In case you've been off the planet for the past two decades, this is Dr. Nick from The Simpsons.

I'm a Big Kid Now!

My little bug is a little over 14 months now and I can't believe how fast he is growing up. He's finally mastered the art of walking, which has actually made my life a little easier because I don't always have to carry him. We can actually run around at the park, and he chases the dog around the house non-stop all day. He also had his very first dentist appointment today, which sadly I couldn't go to because I was working, but dad says he was such a good boy. They even took a picture of him with his new toothbrush and printed it out for us!

Also, we recently bought him a potty. I'm aware that it's probably way too soon to expect my child to learn how to control his bladder, but I figured we'd just introduce the potty to him. So each night before his bath, we sit him on the potty just for the fun of it. Well, tonight he actually peed in it! Then he stood up. Then he peed more on the floor. Well, he at least he half understood the concept. I'm still a very proud mama.

I feel like time is totally flying by. The other day I did a well child exam on a two week old and I was so amazed at how tiny the little baby was. It's hard to think my little man was that small once. Now he's this walking, talking, peeing-on-the-potty machine.... and superman.

Let's fly, let's fly away....

Maybe you've noticed from my title, that this is the sequel to my previous post. I am sitting in Philadelphia's airport trying to bide my time until my flight. I have five hours to kill. Yes, five hours. So what do you do when you have all this spare time in an airport? Well, you drink wine of course! There's this beautiful little restaurant called Vino Volo and I've been sitting here trying all kinds of wines, eating delicious food, and splurging on desert. After all, I deserve it since I just finished my last exam of medical school!

Salute!!

Come Fly with Me....

Well, I'm sitting at the airport waiting to board my flight to Philadelphia so I can take my final board exam of my med school career. I've only ever flown by myself once before and that was going to an AMA conference, but happened to have someone I knew from my school on the flight. I usually get nervous about flying, and even more so now that I'm alone. To top it all off, I'm going on one of those smaller kinds of planes, which just give me the hibee jibees. They usually make all these scary noises, and the landings are never as pretty as a big Boeing jet.

I remember flying to Ireland for my honeymoon and we had to take a small plane to New Jersey before hoping on the long flight to Limerick.  I vomited right after getting off the plane in NJ. Partly because the decent was so rough, but also from my nerves. I just don't like to fly. It's not natural for a billion-pound hunk of metal to defy gravity and fly at the speed of light. NOT NORMAL. But flying to me is better than the alternative, which would be to make a 12 hour drive. And considering I have to miss two days of my clinical rotation to do this thing, the less travel time the better.

The most exciting part to me is getting to stay in a fancy smancy hotel. I LOVE hotels. I would live in one if I could. From the freshly made bed to the bright and shiny bathrooms, hotels just make me feel luxurious (well, I guess it all depends on the actual hotel you stay in). I got a sweet deal where I get dinner and breakfast included in my stay, so I don't have to venture around a city I don't know too well to scrounge for food. Plus I need to actually spend some time preparing for my exam, which I just started to get nervous about. So wish me luck!

Life is Good :)

I cannot believe how fast everything is going by. I just finished my first week of a very important showcase rotation. The anxiety of the first day at a new hospital where you don't know anyone is so stressful, but at the same time I was so excited. I think the more rotations I do, the more comfortable and confident I am. I can only hope that the physicians, and most importantly the residency director, see that. It feels so good to get to do something you truly love doing and get so much fulfillment out of. I feel very lucky coming home each day knowing that I'm doing what I know I was meant to do.

This week really was a hodge podge of all kinds of patients. I got to counsel a patient with new onset diabetes and map out a care plan for him. I also spent a good amount of time doing physicals, which is paramount to family practice. If you can do a thorough physical in a timely manner, then you're golden. I did a morning of maternal-child health, which I got to round on newborn babies and their moms, as well as some sick children in the hospital. I was assigned to a child with an asthma exacerbation that just wasn't getting much better on the current treatment regimen. And being a medical student, the doctors like to give you a lot time to examine the patient, doing your charting, and do some research. So I got to really learn a lot about asthma management in a pediatric patient.

One of my favorite things to do is well-child-checks, which I got my fair share of this week. I saw a lot of infants, which I used to be kind of nervous seeing babies but have grown quite comfortable with it recently. I think now that I'm a mom, I can totally relate to the parents and try to make them feel more comfortable. Also, I've become great at going through developmental milestones since I just try to think back at what Killian was doing at certain ages. I know each kid's different, but it's nice to have my own little model at home to learn from. I was able to talk about the new car seat recommendations with a young mom, and talk about post-partum depression with another. It felt awesome being able to help fellow moms like myself.

I'm having such a great time on my rotation, but unfortunately it has to get interrupted next week to fly down to Pennsylvania to take my COMLEX PE exam. Yes, another test! This one I have to see 12 pseudo-patients, only having 14 minutes to get a history and examine them. Then you get 9 minutes to write a note on them. Seriously? 14 minutes?! I challenge you to time how long your doctor spends in the room with you, and I bet it's a lot longer than 14 minutes. Despite most "acute" visits only getting scheduled for 15 minutes, most doctors take longer than that, which is why they're always running behind! But it's not like a buzzer goes off at that 15 minute mark and they dart out of the room without finishing parts of their exam or discussing treatment options. So the idea of being timed seems pretty unrealistic to me.

So this will be my official LAST exam of my med school career. After today, it's just rotations, interviews, the match, and finally graduation (which is eight months away in case you were wondering). Oh, and by the way, I just found out today that I passed my COMLEX written exam that I took a few weeks ago! One step closer to finally being a "real" doctor.

"Real" Housewives

It was a momentous week here in my household. We have officially gotten cable! Yes, cable television. Since we moved into our place a year and three months ago, we have not had cable TV. We were on a tight budget and decided that spending a ridiculous $80/month wash just not worth it. So we got Netflix instead, which sufficed until I literally watched every episode of Grey's Anatomy, Brothers & Sisters, Rescue me, Crank Yankers, Friday Night Lights.... you get the picture.

Well, since the blessed day we had cable installed I have been GLUED to my couch (during the hours Killian when is sleeping or napping). Boy have I missed TV, particularly the wonderfully trashy "reality" shows. And just my luck, there was an all day marathon of Real Housewives of New Jersey on this weekend. Naturally, I had to catch up on this season! As much as I find it so entertaining that these ridiculously rich women are making fools of themselves, I can't help but get so irritated.

First of all, the title of the show is a complete lie. This women aren't "Real", they're about as fake as Pamela Anderson's breasts. I'm no housewife, but I'm pretty sure being a housewife entails some actual housework.... like doing laundry, dishes, making dinner, and actually taking care of your own children. It's hard work! These women on the show wouldn't know the difference between a Swiffer and a Mr. Clean magic eraser. One particular housewife, who was publishing a cookbook of her mother's italian recipes, didn't even know what cumen was. She even pronounced it "come-in". Seriously? Not to mention there's never a moment on the show where you actually see these women participating in the care of their kids. They literally just spend their time buying overpriced trashy clothes, attending extravagant parties, and fighting with each other. Drama, drama, drama!

It makes me so sad that these are the role models we have on TV. And the fact that these women are now made famous and even more rich because of it is killing me! There are thousands of women who are housewives, homemakers, stay-at-home moms who actually do something that is honorable and productive. And these women just make a mockery of it. I can only hope that when they look back on these episodes they realize how self-absorbed and ignorant they appear, and hopefully will change for the better because of it.

In the meantime, I'll stick to watching my fake medical shows and other great shows like 30 Rock and The Office. And if I ever feel like watching a show about a "real" housewife, I'll check out some I Love Lucy re-runs.

Med School & Matrimony

I just read another fellow medical student's blog about their thoughts on being married and in medical school. It was quite fitting considering a discussion I had with my husband this morning while going for a walk. We were talking about how we couldn't believe how far we've come since we first started school, and how in less than just nine months I'll finally graduate and be a doctor. It's been such an incredible journey and I think that without my hubby (and now a little boy), I would have gone down a totally different path. Not necessarily any worse or any better. Just not the same.

When I first started med school, my then "boyfriend" and I had lived together for about a year. Only about two months into school he proposed. We married the summer after I finished second year just after I took my first step of my board exams (note to fellow med students: I do not recommend trying to plan a wedding and take a very stressful board exam at the same time). I didn't even think twice about getting married while in med school. My husband has been my biggest supporter and always encouraging me, so of course getting married just seemed right.

The fact that my husband was also in grad school at the time and experiencing the same trials and tribulations as me, helped us grow closer and lean on each other for support. We'd both come home after a long day of classes, buckle down and study, then head to bed only to do it all over again the next day. And the one thing we agreed upon was that we'd have a little "us" time on the weekends (unless there was a huge test coming up the next week, in which case we'd spend a bit more time studying). I think that's why so many people in my school ended up dating and later getting engaged or married. Having someone who can share in your experience during such a stressful period definitely makes you feel like you're not alone.

I never could have foreseen where I'd be now when I first started school. Who'd have thought that in the last four years I'd have gotten married and had a baby all while making it through med school? And I can't help but wonder if I wasn't a wife and a mom, would I still be choosing to be a family practitioner? Or would I have picked a field that was more demanding of my time and more competitive? I guess it doesn't really matter because the point is, that I'm happy where I'm at today. More than happy actually, I'm ecstatic! I am so blessed with an amazing family, and I'm about to start a career as a doctor doing something I'm so proud of and truly enjoy doing. It's funny how life just kind of leads you where you never knew you were meant to be.

An Ode to the Working Mom

Today I've officially gained a new appreciation for the working mother. I also have much admiration for the stay-at-home mom, but they are lucky enough not to have to experience the emotional turmoil that goes along with being away from your kid all day. It's a tough thing to balance, being a mom and having a career. On one hand you want to work and earn money for your family, but on the other hand you have this overwhelming "mommy guilt". It's heartbreaking only getting to spend a few hours with your child when you come home. 

Today I got up at six am. Showered and got dressed. Packed my lunch. Made coffee, which the sound of the coffee grinder woke up Killian. Made breakfast (if you call a blueberry bagel an appropriate breakfast). Kissed my husband and my child. Then I ran out the door, with my now cold blueberry bagel in hand. I drove an hour to work. Saw back to back patients all day until 6:30. Drove an hour home.

So it's 7:30 pm and I finally get to see my little man. By now it's late and he's getting tired. So all I really have time to do is give him a bath, put his pj's on, brush his teeth, give him his milk, and read him a bedtime story. Usually I just put him right in his crib after story time's over, but I snuggled him for a few minutes longer because I just missed him so much. 

I spent 10 hours taking care of other people today and only about one and a half hours taking care of my little boy. I can't help but feel like I'm lacking in the mommy department. I don't know how all the working moms out there do it. I guess what helps me is that I love what I do. I'm proud of my work. I enjoy my work. Not everyone can say that. A lot of people don't like their jobs and just do it for the money. I want to be a doctor because I get a sense of accomplishment and satisfaction knowing that I'm helping other people. 

I can't forget to give credit to the working dads out there too, particularly my wonderful husband. He watches Killian during the day and then works in the evening a couple days a week and on the weekends. I'm so grateful to have married a man who is such a good father and works so hard to to take care of our son and works to support our family. Right now with both of our busy schedules, I'm surprised we've even managed to make it work.

Let's face it, being a parent is hard. You want so badly to do what's best for your child, and I think that for every family it's different. For us, it's working to support our family. Then the time that we do have together, we just have to make the most of it. It's not how much time you have, it's what you do with your time. I just have to keep reminding myself of that those days that I feel overcome with mommy guilt. And for all you working moms out there, thank you for being an inspiration to me.

Trust me, I'm (almost) a doctor!

This past week I started my first official sub-I. For those of you who don't know what that is, it's a clinical clerkship you do as a fourth year medical student where you basically work like you're an intern (aka: first year resident) and try to "show-off" your awesome skills and talent as a future physician. They are also referred to as "showcase rotations" for that reason. And hopefully the physicians, residents, and residency director like you enough so that when you apply and later interview at their program, they remembered how great you were during your sub-I that they want you to work for them.

So as I said, this is my first of a couple sub-I's that I'll be doing in Family Medicine. And I have to say I am having a blast! As much as I loved having time off this summer, I forgot how much I missed seeing patients. More specifically, the feeling I get coming home and knowing that I did something to better a person's quality of life. This week has been amazing. I got to see such a wide variety of patients from pregnant women to children to college folks to the elderly. And I got to do basically everything! Joint injections, some osteopathic manipulation, PAP smears, and even counseling an anorexic patient. That's what's so great about being a family practitioner. You literally get to experience the whole spectrum of medicine.

I have to say, though, I've also realized this week how much becoming a mother has changed how I practice and the level at which I can relate to my patients. The handful of OB patients I had, I felt like because I've been in their shoes that I could better explain to them what to expect and care for them with a different kind of empathy than others. I also had a couple women come in for post-partum visits, where I either gave them options and advice on contraception and family planning, talked to them about post-partum depression, and just chatted about how much life has changed being a mom. All things I could talk about before, but having gone through it all myself I feel like I can build a better relationship with my patients. It's one of those "you're not alone" things.

I know it's only been a week, but I can already tell that I made the right decision deciding to going into family practice. I feel like I just fit. Like putting on the perfect pair of shoes that are not only stylish but comfortable. I can see my future and I love it!

One Step Closer

I survived my Step 2 board exams. Weeks of studying, 400 questions, and eight hours later.... I'm still alive. I won't know for a few weeks if I passed or not. The thing is, I don't just want to pass. I want to do well so that I have an edge going into the residency application & interview process. So we'll see. I'm confident that all the hard work and effort I put in will pay off. 

In the mean time I bought a killer suit for the upcoming interview season. I start my first showcase rotation on Monday. So I figured just in case I get asked if I wanted to interview while I'm there, I better be prepared. I'm a strong believer in the idea that you need to dress to impress, which is hopefully what a $400 suit from Banana Republic will do. 

I've also been working on finishing up my residency application. I've had to write a personal statement, which is a page-long essay of sorts talking about why you chose to pursue the field you chose, as well as bragging a bit about what makes you an awesome doctor. It's actually not a very easy task writing about yourself. I'd like to think that writing this blog for the last few months has helped me refine my writing skills. 

Well, that's where I'm at right now. It's been such a relief to get my board exam out of the way, but now it's just onto another obstacle to tackle (meaning my residency application), then it'll be interviews, all while doing Sub-Interships in family medicine. Oh yeah, I have to be a wife and a mother too! Should be an interesting next few months. Naturally, I'll keep you updated :)

Picture Perfect

I recently had Killian's one year pictures done by an amazing photographer, Alyssa Proia. I can't even tell you how happy I am with how them came out, so I'll just show you:

This little boy just melts my heart. I can honestly say that my life wouldn't be complete without him. He has become our world. We are so very blessed.

I think I can, I think I can

Three days until my boards..... which is why I haven't been real chatty recently. This has pretty much been my life:

Coffe, study materials, and my computer (for online question banks and periodically checking facebook).

I've turned into a zombie. I've even gone as far as to bring my study materials to the gym. My very understanding and compassionate husband quizzes me throughout the day. The only time I'm not studying is when I'm taking care of the little man, who is absolutely opposed to me doing anything but paying attention to him.

I promise to be a more active participant of my blog after Monday. And a week after that I start a new rotation, so I'll have loads more to talk about. That's if I survive my test..... Wish me luck!

P.S.
9 months and 2 weeks until graduation. Holy cow!!!

Role Doctor

I apologize for being AWOL the last week or so. I was up in Maine doing some school stuff, and I've been pre-occupied with studying for my boards. Not to mention, I have my residency application looming over my head. And it's hard to not feel guilty taking time to write a blog post when there's all these other important things to do that determine the fate of my future as a physician. Still, writing on here is very cathartic for me and I should really do it more.

Anyways... I read an article on CNN.com this morning that begged the question, "Should Doctors Practice What They Preach?" Before even reading it, I thought "Of course! That's a stupid question!" But really, is your doctor a "Role Doctor"? (Yes, I made that up!). The article was actually written by a physician, who went on to describe another doctor he worked under in medical school was quite overweight, chain-smoked, and drank Mountain Dew all day. He talks about one experience where Dr. McUnhealthy was lecturing an obese patient to diet and exercise, and the patient responded with, "When's the last time you skipped a meal?" I couldn't help but laugh out loud. The patient rolled his eyes as he walked out the door.

I was reminded of this one doctor I worked with while on my surgery rotation who went out to his car in between every surgery to smoke. One day he just finished doing a resection of a cancerous lung tumor and STILL left to go suck down some nicotine. You'd think that performing lung biopsies and treating patients with cancer on a regular basis would be a good deterrent from smoking, but I guess not for him. And it's certainly hard for a patient to take a doctor's smoking cessation advice seriously when said doctor wreaks of cigarettes himself.

It seems kind of obvious to me that your patients will take your advice more seriously if you are a good role model. Maybe they will think that if you (the doctor) can live a healthy lifestyle by exercising, eating healthy, and not smoking despite having a very demanding job, then they could too. I mean, would you ever hire a personal trainer who was overweight? Or take financial advice from someone who has money problems of their own?

Thankfully I have a great doctor who I can actually look up to. The last time I saw her, I was telling her how I just ran my first 5k. She was so supportive and happy for me. She then encouraged me to sign up for another one next month that she's actually running in herself. Now there's a good Role Doctor!

I bet you wish your Dr.
looked this this!

Now I'm not saying you have to look like the pseudo-doctors from Grey's Anatomy to be a good physician. It certainly takes a lot more to get your patients to actually follow-through with your advice. For one, you have to be relatable, trusting, honest, empathetic.... just to name a few. But it certainly helps to if you can lead by example, which is what I hope to do as a doctor. Just like I try to do as a mother.

Love & Marriage

Two years ago yesterday I married my best friend. My husband is truly my soulmate. Yes, I'm going to get all mushy on ya here. I spend a lot of time talking about myself on my blog and certainly brag about my kid, but I don't mention my hubby too often. Well, that's because usually people tend to complain about their significant others, and I just don't have anything bad to say about the guy. Also, I am a strong believer that your personal/family drama is better kept to yourself and not displayed on facebook/twitter/blogspot. 

Since it's our anniversary, though, I think it warrants a good blogpost. I met my husband in college. We were grouped together in anatomy lab and did a research project on "Laughter, the best medicine?" (which pretty much sums up our relationship). Even though I thought he was cute, I didn't think anything of him until we touched knees one day. I kid you not, when I say that there was a spark. I went home that night and just knew I had to be with him. Little did I know that our innocent knee-touching would lead to us eventually dating, moving in together, getting married, and then having a beautiful baby boy. It's unreal how life just happens.....

To celebrate two very healthy and happy years of marriage we got all dolled up and went out to dinner, followed by coffee and desert at a cute little place downtown. As we were walking back to our car, a group of women who were dining outside stopped us and asked if we were on our first date. My husband said, "No, actually it's our two year wedding anniversary, but we're flattered!" I think it's cute that people see us like we just started dating, like we were still excited to be together (which we are!).

I kept saying all night that I can't believe it's already been two years. I can honestly say I am just as happy, if not more, than the day we got married. No relationship is perfect, but there's something here that just works. My husband is the love of my life and not only is he an amazing husband, but he's the best father. I can't wait to see what the future holds for us.

"Baby since the day you came into my life, you made me realize that we were born to fly. You show me everyday new possibilities. You prove my fantasy of what love could really be." ~ John Legend