OK, I'm not actually an official MSIV (Med Student fourth year) yet. We haven't results back from our OSCE (observed patient exams) or MSIII finals on Wednesday and Friday, respectively. But I feel pretty good about both. It was a long week of studying for the latter with many of my classmates back in the cafeteria with the MSIIs (actually now MSIIIs) studying for Step 1 Boards.
So now it's a nice 3-day weekend (for Memorial Day) to work on my EM residency spreadsheet and try to nail down audition rotations. I've applied to several programs for Fall rotations, but only have August really nailed down. Arrowhead in Colton, CA is the only DO program I plan to apply to and it's in driving distance so I can see the family on the weekends. The others are out of state and, if I get all three, would mean another long season away from the family.
I'm also doing my best to get back into shape. Swimming is going well, other than missing Friday. I still have a few hours to get a workout in today. Biking is coming along slowly. I've been taking 25 mile rides once or twice a week plus spinning for 40 minutes her and there for about three weeks. Yesterday I pushed it up a notch and did a 52.5 miler solo. It was painful when I bonked at about 25 (only had a water and a glass of OJ prior) so I stopped for Gatorade and a snack. That really helped. I think I went through five 16oz water bottles in just over 3 hours at close to 100 degrees.
I'm loving my Garmin 305 even though I'm using less than half the features. It's cool to see your ride on the desktop software and then overlaid on Google maps. However, I went a little on the HR zone, speed and cadence alarms and those got a bit annoying.
It all must be doing something. I'm down to 208lbs from 220 in Fort Wayne 5-6 weeks ago. I've got nine more weeks until I rotate at Arrowhead. I hope to be back to my pre-med weight of 195 by then. Emergency is one those jock/granola/outdoorsy kinda of specialties where being in good shape will certainly help me feel like I belong.
Along with work on my EM program spreadsheet, I need to start thinking about Boards - and start using my online question bank (USMLEworld) to take practice tests. It's not nearly as stressful as Step 1 last year, but I'm aiming for 600 on COMLEX Step 2 and 230 on USMLE Step 2. The numbers are arbitrary but both represent about a Standard Deviation over the means. Improvements over my slightly lower but quite respectable Step 1 scores will look good for applications.
Back to my EM day dreaming...I mean research.
Sunday, May 27, 2007
Tuesday, May 22, 2007
Third year rotations over!
I finished RadOnc/Research last Friday and actually passed my Family "shelf" test the same day. I studied pretty hard for the latter and it paid off since it was a very hard test. Wish I had a better score, but passing is passing at this point.
RadOnc is for the most part off my radar. I like it, the lifestyle, income and tech is great. But Emergency is probably a better for me, and certainly for our family. So instead of studying for the Third Year Final on Friday, I've been working on EM spreadsheet and trying to finalize audition rotations for the Fall. I have a couple lined up, Arrowhead, CA in August and Christiana in November, but am still working on Tufts for October.
It's just so hard to get into studying anymore. I spend an hour or so reading EM posts on Studentdoctor.net this evening reliving the Match (March madness) for the Fourth years. Pretty scary and seems like EM is getting pretty competitive. Looks like I'll have to list a lot of schools to make sure I don't end up scrambling for a residency spot.
My diet is going pretty well. I'm under 210 for the first time in awhile. I'm swimming regularly and getting in decent shape. I'm also fitting in more than one road bike workout a week. I just installed the Garmin Edge 305 and am having a blast with it using a tenth of the functions (HR, GPS, cadence, etc.). It feels great to get out there and I can't wait to get my legs back after several years of studying. Only 15 or so pounds to go.
Time to get back to studying the 60 lectures were going to be tested on this Friday. At least its not as stressful. It just doesn't feel like grades matter at this point. I have my OSCE tomorrow which is a test of four patient encounters. The actors/patients grade us and then our chart notes are graded. I'm pretty much winging it. It I fail either, I just try again. No long term consequence for these. Step 2 in July is another story though...
RadOnc is for the most part off my radar. I like it, the lifestyle, income and tech is great. But Emergency is probably a better for me, and certainly for our family. So instead of studying for the Third Year Final on Friday, I've been working on EM spreadsheet and trying to finalize audition rotations for the Fall. I have a couple lined up, Arrowhead, CA in August and Christiana in November, but am still working on Tufts for October.
It's just so hard to get into studying anymore. I spend an hour or so reading EM posts on Studentdoctor.net this evening reliving the Match (March madness) for the Fourth years. Pretty scary and seems like EM is getting pretty competitive. Looks like I'll have to list a lot of schools to make sure I don't end up scrambling for a residency spot.
My diet is going pretty well. I'm under 210 for the first time in awhile. I'm swimming regularly and getting in decent shape. I'm also fitting in more than one road bike workout a week. I just installed the Garmin Edge 305 and am having a blast with it using a tenth of the functions (HR, GPS, cadence, etc.). It feels great to get out there and I can't wait to get my legs back after several years of studying. Only 15 or so pounds to go.
Time to get back to studying the 60 lectures were going to be tested on this Friday. At least its not as stressful. It just doesn't feel like grades matter at this point. I have my OSCE tomorrow which is a test of four patient encounters. The actors/patients grade us and then our chart notes are graded. I'm pretty much winging it. It I fail either, I just try again. No long term consequence for these. Step 2 in July is another story though...
Sunday, May 06, 2007
RadOnc
I took the first two days of this month's Radiation Oncology research rotation to nail the Surgery shelf test. They only told me that I passed, but I'm sure that I did much better this time. No stupid questions trying to redefine anatomy on this version of AZCOM's homemade tests.
I also spent a lot of time catching up with classmates while suffering through on campus didactics. I sure didn't miss the boring lectures during the last four months. However, it was great to hear how everyone is doing, what they are planning on going into, rotation experiences, etc.
Then I was pleasantly surprised to learn that my Preceptor this month is letting me see interesting patients and get in on the cool procedures. I even got to see how a dosimetry plan is generated by the physists for external beam treatment of breast cancer. The best part so far though was helping to insert brachytherapy catheters into guys' perineums and womens' breasts. We then deposited (temporarily or permanently) radioactive sources like Iodine131 into specific catheters at specific locations in the lesions. They actually had most of the surgical "cool" factor to them, but no suturing or Bovey aroma. On the most recent no urologist was present, so I did their job of placing all the catheters.
Most of my time though is spent reading through patient records and filling out research surveys for each one. We are trying to publish the largest post-prostatectomy external beam radiation therapy study to date. So it's a lot of paperwork, but I have the opportunity to get my name on a published study. The office is the largest private RadOnc group in the country and they enter more patients into studies than any RadOnc group in the country, including Universities! So I think they know what they are doing.
This Friday I'm going the St. Joe's office to see their Gamma and Cyber Knife systems. That will be awesome, and it will allow me a chance to ask the Attending what is happening with the paper I submitted to him a few months ago for publishing. I had a minor contribution with a classmate, but any published papers look good.
After almost two weeks doing RadOnc and learning that one of our fourth year students matched RadOnc at Drexel, I think it is much more doable. It would mean 60+ applications, hopefully 5-10 interviews and then a move to who knows where. But the Docs in my office feel I have a shot at RadOnc and should go for it.
At this point, I'm trying to decide whether to try for both RadOnc and EM in the Match or just EM. Going after both means more applications, more expensive interviews and probably listing a couple RadOnc programs as my first and second choices then seeing what happens next March. If I stick with EM, I might be able to get an early contract at a DO program and skip all the time, expense and stress of the Match. The Arrowhead, CA program I'm going to rotate at in August may just work into that plan. However, the income, technology and patient contact of RadOnc is very attractive. I'm tempted to try for RadOnc to see what happens with EM as my backup.
I just finished a bike ride with my attending this morning. We started at his brand new 3800sf house in North Scottdale. What a place! According to Zillow.com, nothing in his zip code goes for less than a million, even the lots start at $500k. And he's less than two years out of residency! He laid out how his contract works with two years guaranteed income then full partner. It's a pretty good gig, and the Docs all say that likely changes to medical reimbursement shouldn't have a huge negative impact on RadOnc. I have a hard time believing there won't be some decreases when procedures can easily run from $100k to $200k, but even a 10% decrease in reimbursements would leave RadOncs as some of the best paid Docs in medicine.
My thinking at the moment is to audition at Arrowhead in August, hopefully Maricopa ER in September and a RadOnc program in October (one that has 2+ slots for non MD/PHDs, if such a thing exists). I may need to double book November with both a RadOnc and an EM program, doing the RadOnc rotation if it's still in the running.
I hate to make things so complicated, but I'm not ready to up on a shot at RadOnc yet either. Two more weeks to go on this rotation along with a lot of studying for the Family shelf test. There's always a chance, however slight, that things will become clearer.
I also spent a lot of time catching up with classmates while suffering through on campus didactics. I sure didn't miss the boring lectures during the last four months. However, it was great to hear how everyone is doing, what they are planning on going into, rotation experiences, etc.
Then I was pleasantly surprised to learn that my Preceptor this month is letting me see interesting patients and get in on the cool procedures. I even got to see how a dosimetry plan is generated by the physists for external beam treatment of breast cancer. The best part so far though was helping to insert brachytherapy catheters into guys' perineums and womens' breasts. We then deposited (temporarily or permanently) radioactive sources like Iodine131 into specific catheters at specific locations in the lesions. They actually had most of the surgical "cool" factor to them, but no suturing or Bovey aroma. On the most recent no urologist was present, so I did their job of placing all the catheters.
Most of my time though is spent reading through patient records and filling out research surveys for each one. We are trying to publish the largest post-prostatectomy external beam radiation therapy study to date. So it's a lot of paperwork, but I have the opportunity to get my name on a published study. The office is the largest private RadOnc group in the country and they enter more patients into studies than any RadOnc group in the country, including Universities! So I think they know what they are doing.
This Friday I'm going the St. Joe's office to see their Gamma and Cyber Knife systems. That will be awesome, and it will allow me a chance to ask the Attending what is happening with the paper I submitted to him a few months ago for publishing. I had a minor contribution with a classmate, but any published papers look good.
After almost two weeks doing RadOnc and learning that one of our fourth year students matched RadOnc at Drexel, I think it is much more doable. It would mean 60+ applications, hopefully 5-10 interviews and then a move to who knows where. But the Docs in my office feel I have a shot at RadOnc and should go for it.
At this point, I'm trying to decide whether to try for both RadOnc and EM in the Match or just EM. Going after both means more applications, more expensive interviews and probably listing a couple RadOnc programs as my first and second choices then seeing what happens next March. If I stick with EM, I might be able to get an early contract at a DO program and skip all the time, expense and stress of the Match. The Arrowhead, CA program I'm going to rotate at in August may just work into that plan. However, the income, technology and patient contact of RadOnc is very attractive. I'm tempted to try for RadOnc to see what happens with EM as my backup.
I just finished a bike ride with my attending this morning. We started at his brand new 3800sf house in North Scottdale. What a place! According to Zillow.com, nothing in his zip code goes for less than a million, even the lots start at $500k. And he's less than two years out of residency! He laid out how his contract works with two years guaranteed income then full partner. It's a pretty good gig, and the Docs all say that likely changes to medical reimbursement shouldn't have a huge negative impact on RadOnc. I have a hard time believing there won't be some decreases when procedures can easily run from $100k to $200k, but even a 10% decrease in reimbursements would leave RadOncs as some of the best paid Docs in medicine.
My thinking at the moment is to audition at Arrowhead in August, hopefully Maricopa ER in September and a RadOnc program in October (one that has 2+ slots for non MD/PHDs, if such a thing exists). I may need to double book November with both a RadOnc and an EM program, doing the RadOnc rotation if it's still in the running.
I hate to make things so complicated, but I'm not ready to up on a shot at RadOnc yet either. Two more weeks to go on this rotation along with a lot of studying for the Family shelf test. There's always a chance, however slight, that things will become clearer.
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