It's been a busy month. For the first couple of weeks, my "cold" continued to get worse - to the point that I think I had walking pneumonia. My preceptor (Dr. Wiss) wrote me a prescription for a Z-pack and in 24 hours I was feeling 100% better. I'm sure my immune system was weakened by the stress and exhaustion. The ironic thing is that I had two of my easiest rotations yet over January.
The first two weeks of the New Year were supposed to be Neuro. However, my preceptor, Dr. Winograd, took vacation over the first week so it ended up as a one week rotation. I saw a lot during that week though and gained a new appreciation for neurology. It was actually quite fun, but would be too narrow to interest me from a career standpoint.
Becky's relatives then arrived for an extended stay. Her mom and significant other (S.O.) started working on a long list of home projects that we needed done to get the house ready to sell. it was a great help since I was worthless between being sick, traveling, new rotations and playing with the kids. In fact, I've been a terrible host.
The second half of January was a rotation in gastrointestinal medicine. However, the preceptor, Dr. Wiss, didn't make me go to the hospital for colonoscopies and procedures. Normally I would have loved to get in some procedures. But in this case I could rest and try to recover. The second week I missed most of my clinic time with my last two interviews, to St. Vincent's and Case/Metrohealth/Cleveland Clinic. In the end I worked one full day and three half days!
The interviews went great. I really enjoyed seeing many of the residents I got to know at St. Vincent's and they made it clear they would love to have me. The only reason I'm not ranking the program high is that Toledo is in a depression, like Detroit and most of Michigan, so Becky would have a difficult time getting a job. In fact, the program is very similar to UConn: friendly, great training, good facilities, good patient volume and some good attendings.
Case Western was new to me and I ended liking it more than I expected. The program seemed very good with great didactics and friendly residents, attendings and staff. It felt like this familiar attitude is a Midwest culture thing. And for a county program (Metrohealth) it is pretty cushy and well supported. Moreover, you spend 1/3 of your time at Cleveland Clinic (they pay 1/3 of your salary) and, while not as glitzy as I imagined, the place is pretty impressive. Finally, while Cleveland certainly offers more job opportunities for Becky than Toledo, the city sure showed signs of economic hardship. At this point, I will probably rank it fourth or fifth.
I enjoyed a rare couple weeks of being a slacker by sleeping more, riding our new mountain bikes on family trips to local mountain trails and playing some World of Warcraft with the boys. They are now at the age that they enjoy social games, whether playing with me or friends from school. And while WOW isn't that impressive from a graphics or class/race aspect, it plays on even my dinky three-year-old ultralight notebook.
This week I started Trauma Surgery at Maricopa county. It's kind of like a long second look at the EM residency program and a warm-up for residency. However, I'm feeling like a glutton for punishment when senioritis is starting to take over. We start at five or six am everyday and end at five or six pm. Then it's at least a 40-minute commute into downtown. Worse, with PAs, PA students, interns, residents and fellows on the service with me it's very slow. I've had one patient each day this week and got to do a couple procedures for the first time today: a foley and a bronchial lavage of blood from an motorcyclist vs. semi victim (without helmet of course).
Maricopa isn't looking too impressive at this point. I like the residents, but the volume is slow, the facility adequate at best and, worst of all, the hospital is on probation with JHACO. When residents joke about the place closing down, you really have to consider the implications.
I'm just getting up to speed now and tomorrow, on day five, we have three new residents replacing the experienced ones that were doing most of the work this week. Tomorrow I will one of the "experienced" people on the service! I'm just thankful that I will miss most of nest week while I travel to Christiana and Johns Hopkins for second looks. I may ask for Monday off even though I don't fly until Tuesday just so I have a day to rest up.
I got a 92% on my neuro test, so now it's time to start studying for Critical Care test. That is once I get used to my new schedule. I'm exhausted because I can't fall asleep until 11 or 12 and then get up at 4 or 5. And I still need to find a way to fit workouts in during the week. I finally stopped by an LA Fitness to swim after work today only to find the pool was an unattended facility off by itself with a bunch of ducks swimming laps! Obviously that wasn't going to do, so I'm still looking for something outside of our weekend mountain bike rides to keep healthy.
Thursday, January 31, 2008
Tuesday, January 01, 2008
New Year's Eve - it's 2008!
I had many possible choices for my New Year's resolution, including getting into shape, graduating from medical school, getting one of my top residency selections and staying healthy (this cold is still holding me back). I'm going attempt all of them for an ambitious 2008.
Tucker and his family came over for the evening. The kids get along great and seemed to have a great comparing Rock Band for the Xbox and Guitar Hero III for the Wii. The former has drums and a microphone, but the latter has much better songs.
It was a pretty laid-back evening with some wine, a baked potato bar and a lot of socializing. Tucker and I agreed that our motivation for medical school is pretty low right now. Fourth year you just want to get your residency slot, not get as many patients as possible on rotation or work your tail off to impress attendings. Makes me wonder what I was thinking when I scheduled three tough rotations for end of fourth year: Trauma Surgery; Internal Medicine Sub-I; and Critical Care. At least I have May off for our long-awaited family vacation.
We celebrated New Year's on New York time so Tucker and his family could get home at a reasonable to avoid the drunks and have the kids in bed before midnight. The boys and I stayed up until New Year's local time and watched the apple, but it was kinda anti-climatic.
Here we are on January 1st, 2008 and we're just lounging around. Becky went for a run, I'm filling up Kleenex boxes with used tissue and the boys are playing Xbox.
My most important goal for today is get my Thank You cards out for the New England interviews I had two weeks ago. The holidays, being sick and the PE exam slowed me down, but the cards are my desk and the task has been in the back of my mind for days and days. Time to stop procrastinating. I finally got caught up on this blog, so that's a good start.
Tucker and his family came over for the evening. The kids get along great and seemed to have a great comparing Rock Band for the Xbox and Guitar Hero III for the Wii. The former has drums and a microphone, but the latter has much better songs.
It was a pretty laid-back evening with some wine, a baked potato bar and a lot of socializing. Tucker and I agreed that our motivation for medical school is pretty low right now. Fourth year you just want to get your residency slot, not get as many patients as possible on rotation or work your tail off to impress attendings. Makes me wonder what I was thinking when I scheduled three tough rotations for end of fourth year: Trauma Surgery; Internal Medicine Sub-I; and Critical Care. At least I have May off for our long-awaited family vacation.
We celebrated New Year's on New York time so Tucker and his family could get home at a reasonable to avoid the drunks and have the kids in bed before midnight. The boys and I stayed up until New Year's local time and watched the apple, but it was kinda anti-climatic.
Here we are on January 1st, 2008 and we're just lounging around. Becky went for a run, I'm filling up Kleenex boxes with used tissue and the boys are playing Xbox.
My most important goal for today is get my Thank You cards out for the New England interviews I had two weeks ago. The holidays, being sick and the PE exam slowed me down, but the cards are my desk and the task has been in the back of my mind for days and days. Time to stop procrastinating. I finally got caught up on this blog, so that's a good start.
Playing with Santa's gifts
The weekend before New Year's was spent riding our new bikes, fixing their flat tires and playing Rock Band. The boys are also playing their new single player games as well, but Rock Band is the most popular, especially with their friends.
I did get some news. My Neuro rotation won't start until January 7th because my preceptor is taking the week off. So my rotation is basically going to be one week. If I can get motivated, that should give me plenty of time to read my Neuro book in preparation for the post-rotation exam.
I'm writing this from my notebook as we manged to confirm that the desktop PC is dead. The kids and I would love a new mid-level gaming PC, but it's going to have to wait after an expensive Christmas. I might have to forego the iPod Touch again and get a new PC for mine and Connor's Birthday presents.
I did get some news. My Neuro rotation won't start until January 7th because my preceptor is taking the week off. So my rotation is basically going to be one week. If I can get motivated, that should give me plenty of time to read my Neuro book in preparation for the post-rotation exam.
I'm writing this from my notebook as we manged to confirm that the desktop PC is dead. The kids and I would love a new mid-level gaming PC, but it's going to have to wait after an expensive Christmas. I might have to forego the iPod Touch again and get a new PC for mine and Connor's Birthday presents.
Level 2 PE in Philadelphia
I left on Thursday the 27th for Philadelphia and finished reading the FirstAid book's mini-cases on the plane. However, I had acquired a nasty virus that was wearing me down. By the time I go the hotel I was exhausted and hadn't started to practice writing out the full cases.
After a long nap I managed to write out 4-5 cases and review another 10 or so. I didn't feel well prepared but knew that passing is all I need and sleep was probably more important. Luckily the cold and nap didn't keep me from getting a decent night's sleep.
The proctors running the exam were nice enough and really explained everything in detail. None of us examinees were nervous when it was time to start. After the first four cases we had lunch. Then four more cases before a short 15-minute break. After the last four cases, I left as quickly as possible to catch my flight back to Phoenix.
The PE exam seemed like most things in the osteopathic world - a joke designed to pad AOA egos and save face for them in front of AMA MDs. I am pretty disgusted that I had to spend over $1500 and two days for a brain-dead test with actors worse than the ones we had for on-campus standardized cases. I found the cases in the FirstAid book on the USMLE Step 2 CS much tougher and more realistic.
If the AOA and osteopathic community were really interested in improving patient care and physician education they would have tried something new instead of just copying the allopathic tests for millionth time.
My irritation with the NBOME and AOA was almost enough to make me forget how irritated I was with their preferred hotel, Marriott, for nickle and diming me bill to the point of being a rip off.
The flight home was fine and allowed me a chance to read up on my forthcoming Neurology rotation. But to top the trip off, I arrived home to find out that our four year old desktop PC had died.
After a long nap I managed to write out 4-5 cases and review another 10 or so. I didn't feel well prepared but knew that passing is all I need and sleep was probably more important. Luckily the cold and nap didn't keep me from getting a decent night's sleep.
The proctors running the exam were nice enough and really explained everything in detail. None of us examinees were nervous when it was time to start. After the first four cases we had lunch. Then four more cases before a short 15-minute break. After the last four cases, I left as quickly as possible to catch my flight back to Phoenix.
The PE exam seemed like most things in the osteopathic world - a joke designed to pad AOA egos and save face for them in front of AMA MDs. I am pretty disgusted that I had to spend over $1500 and two days for a brain-dead test with actors worse than the ones we had for on-campus standardized cases. I found the cases in the FirstAid book on the USMLE Step 2 CS much tougher and more realistic.
If the AOA and osteopathic community were really interested in improving patient care and physician education they would have tried something new instead of just copying the allopathic tests for millionth time.
My irritation with the NBOME and AOA was almost enough to make me forget how irritated I was with their preferred hotel, Marriott, for nickle and diming me bill to the point of being a rip off.
The flight home was fine and allowed me a chance to read up on my forthcoming Neurology rotation. But to top the trip off, I arrived home to find out that our four year old desktop PC had died.
Christmas 2007
My dad and stepmother came into town from California and stayed for a few days. It's always fun to have company for the big holidays and this was no exception. For Christmas Eve we started a new tradition of having salmon and then had a more standard honey-baked ham on Christmas Day.
Christmas Eve we let the boys open their presents from relatives and us. They knew the bikes were the big ticket item, but we pleased to get two of their most desited Xbox 360 games and a few appropriate books. I gave Grandpa a hilarious book from the Onion called Our Dumb World that the adults laughing to tears while the boys tried out their new games.
Christmas morning we had our traditional one present from Santa and several "love presents" in their stockings. The one present was the hard-to-get present for 2007 that we managed to snag from at a local vendor. Rock Band doesn't have as many good songs as we expected or would like, but the kids love using the guitar, drums and microphone to score points (get fans). In the sleep-overs they have had with friends since Christmas, they played for hours screeching out REM, the Clash and the Who. It is quite funny to watch and hear.
I started playing an online game on the PC afterwards as a way to procrastinate from studying for my PE exam on Friday the 28th. That and buying replacement tubes for bikes.
Christmas Eve we let the boys open their presents from relatives and us. They knew the bikes were the big ticket item, but we pleased to get two of their most desited Xbox 360 games and a few appropriate books. I gave Grandpa a hilarious book from the Onion called Our Dumb World that the adults laughing to tears while the boys tried out their new games.
Christmas morning we had our traditional one present from Santa and several "love presents" in their stockings. The one present was the hard-to-get present for 2007 that we managed to snag from at a local vendor. Rock Band doesn't have as many good songs as we expected or would like, but the kids love using the guitar, drums and microphone to score points (get fans). In the sleep-overs they have had with friends since Christmas, they played for hours screeching out REM, the Clash and the Who. It is quite funny to watch and hear.
I started playing an online game on the PC afterwards as a way to procrastinate from studying for my PE exam on Friday the 28th. That and buying replacement tubes for bikes.
Getting ready for Christmas and Level 2 PE
I spent the vast majority of my time preparing for Christmas, not the PE exam. I inconsistently read the FirstAid book for allopathic version of the test, USMLE Step 2 CS. But didn't get very far. Instead, Becky and I laid out the plans for Christmas and I got to shopping.
The big item this year ended up being mountain bikes. We are all having a rough time getting back into shape and definitely ate too much crap (me while traveling the last fours months). I haven't gone swimming or biking more than a couple times each even though Becky now has a road bike and the kids are old enough to leave them home alone for an hour or so. Moreover, the kids had gotten a little tired of swimming, and we of forcing them to go to practice.
So I decided that mountain biking would be something we could all do as a family on weekends an the boys could even do after school in the local "wash". That's a Phoenix term for overgrown drainage ditches. They are the size of a river to handle floods, but are dry 99% of the time, so coyotes, rabbits and human use them most of the year.
This was an expensive decision for us at this point, but Becky and I committed that we'd get our tushes out of the house on weekends and spent some quality with our kids. The boys and I visited the top local store, Swiss American Cycling, and the immediately fell in love with the idea of mountain biking. Probably more accurately, with the idea of getting new bikes. Colton had always had hand-me downs from his brother, so he was ecstatic about gettin a cool new bike.
We picked them up on Saturday before Christmas so the boys would have something to do other than start their two week break glued to the TV. We managed to get the bikes home and surprise them, only after realizing that we'd be getting a new bike carrier. After very minimal set-up the boys and I went out for a quick ride.
They were tentative, Colton less so, but really enjoyed it. On Sunday Connor had a head-over-handlebars crash in the street and hurt his wrist, so Colton and I went exploring. The following day all four of us went for an easy ride. I still felt the boys were excited, just not as passionate about it as I would have liked. That changed after Christmas went to some BMX trails by AZCOM with lots of obstacles, jumps and gullies. Now they boys are huge fans and can't wait to go riding every day. It's starting to feel like money well spent.
Our biggest hassle has been popped tire tubes. I'm putting on Slimes now, but we had 1-2 punctures per ride for the first week! That gets old fast.
The big item this year ended up being mountain bikes. We are all having a rough time getting back into shape and definitely ate too much crap (me while traveling the last fours months). I haven't gone swimming or biking more than a couple times each even though Becky now has a road bike and the kids are old enough to leave them home alone for an hour or so. Moreover, the kids had gotten a little tired of swimming, and we of forcing them to go to practice.
So I decided that mountain biking would be something we could all do as a family on weekends an the boys could even do after school in the local "wash". That's a Phoenix term for overgrown drainage ditches. They are the size of a river to handle floods, but are dry 99% of the time, so coyotes, rabbits and human use them most of the year.
This was an expensive decision for us at this point, but Becky and I committed that we'd get our tushes out of the house on weekends and spent some quality with our kids. The boys and I visited the top local store, Swiss American Cycling, and the immediately fell in love with the idea of mountain biking. Probably more accurately, with the idea of getting new bikes. Colton had always had hand-me downs from his brother, so he was ecstatic about gettin a cool new bike.
We picked them up on Saturday before Christmas so the boys would have something to do other than start their two week break glued to the TV. We managed to get the bikes home and surprise them, only after realizing that we'd be getting a new bike carrier. After very minimal set-up the boys and I went out for a quick ride.
They were tentative, Colton less so, but really enjoyed it. On Sunday Connor had a head-over-handlebars crash in the street and hurt his wrist, so Colton and I went exploring. The following day all four of us went for an easy ride. I still felt the boys were excited, just not as passionate about it as I would have liked. That changed after Christmas went to some BMX trails by AZCOM with lots of obstacles, jumps and gullies. Now they boys are huge fans and can't wait to go riding every day. It's starting to feel like money well spent.
Our biggest hassle has been popped tire tubes. I'm putting on Slimes now, but we had 1-2 punctures per ride for the first week! That gets old fast.
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