Why I Chose Ob/Gyn – Obstetrics Portion

Photo Cred: gnelyseo on Flickr Creative Commons
Photo Cred: gnelyseo on Flickr Creative Commons

 

Day 1 of Medical School:

I’m showered, made-up, and well-slept. As a newly wed in a new city embarking on an exciting journey, I possess a palpable eagerness akin to the first day of Kindergarten. Although I am somewhat intimidated and terrified, my mind is focused and eager to get going with this adventure to becoming a doctor.

I confidently write my specialties of choice on the welcome questionnaire.

  • Pediatrics or
  • Emergency Medicine

 

Fast Forward 4 Years to Match Day:

I’m nervous, lactating, and definitely not well-slept. As a new mom to twins in a familiar room holding an envelope encasing my future, I can’t help but feel nauseated. I open it to find relief in the contents and then see a large screen flash my “MS1 chosen specialties” alongside my ERAS picture and actual Match results revealing a totally different future than I envisioned in chapter 1.

Match Day 2013
Match Day 2013

It’s then I realize that only a very small minority of our class actually applied and matched into the specialty they came to medical school expecting to train for.

 

So, how’d I end up here?

Perhaps the most stressful decision we make as medical students is what specialty we will go into. I had distinct plans to avoid any surgical specialty, specifically including Ob/Gyn, mostly out of fear that surgical specialties were not compatible with having a family. I also had an underlying belief/worry that I did not possess the required moral fortitude or tactile skills to operate and lead in high-stress environments.

In fact, even after rotating through these specialties and realizing I enjoyed being in the OR, I still spent the next several months in a mental debate with myself creating reasons I should choose a non-surgical specialty I liked instead of this surgical one I loved. At the end of it all I simply could not justify choosing something I was less apt in and enjoyed less based purely on what turned out to be misguided fears…especially after all the time, money, and effort I had put in to simply being able to make that choice.

Ob/Gyn had several drawing factors for me, some of them I’ve written about in the past. One of those, what I call the “Happiness Factor” was particularly appealing. Despite crazier hours and more intense training than some of the “lifestyle” and “cognitive” specialities, I was happier on my Ob/Gyn rotation than any other. Additionally, I felt like the Obstetrics aspect was uniquely happy. Where else in a hospital are people EXCITED to get admitted?

That being said…

While Obstetrics actually is 90% YAY-BABY-DAY(!), one must not forget that there remains a less-discussed, ever-present 10% which is purely heart-wrenching. This field is usually good, but when it’s not good…it’s downright terrible.

  • Delivering babies you know will never cry…holding your breath for the most deafening silence you’ll ever know.
  • Cradling babies born living, but far too early for modern medicine to help.
  • Telling a mom there is no heartbeat.
  • Taking care of parents who know their baby will be born with life-threatening, limiting, or lethal anomalies.
  • Hugging grieving parents after an unexpected newborn death.

These are all things I’ve done, most of them more than once. These are tragic circumstances which come with the territory. At one point in my life I thought this was made okay by the fact that they are bookended by lots of “He’s soooo cute” squeals to a lovely soundtrack of crying newborns. I’ve come to realize, this 10% is actually a sacred part of my job. Knowing I have the opportunity to guide these families through scary, uncharted waters and give them the tools to find a glimmer of happiness in the unthinkable is what makes this worth it. These women and their families deserve attentive, compassionate, focused care on their darkest day.

Taking care of women through their pregnancy, happy or sad, is not just a job, it’s a privilege. I am welcomed into the most exciting, scary, heartbreaking, wonderful, confusing and intimate of times. The physical, emotional, and social aspects of pregnancy, labor, & delivery make the obstetric part of my job continually exciting.

Maybe the new just hasn’t worn off yet, but even after hundreds, if not thousands, of birth days it still feels like a privilege every time I set foot in a delivery room.

Ob/Gyn Residency – Month 1

Danielle Jones, MDSorry I’ve been away so long! Between graduating medical school, moving across the state with 6mo old twins, traveling, welcoming our new Au Pair, Odelia, and starting residency, life has been hectic, to say the least. I can only imagine life will continue to be hectic(-er), but now that I’m back to some what of a predictable routine my goal is to blog more frequently. Not for y’all – I’m sure you didn’t miss me a bit (*tear*) – but for me, as I truly enjoy writing here and I fully intend to keep doing it.

July 1 marked the first day of residency, with a week of orientation preceding, and so far it’s been a nicely terrifying adventure. I started on Ambulatory Gynecology, so I feel like I’ve been eased into everything very slowly. My hours have been fine and I’ve been able to keep up fairly well with things, but again – I’m on basically the easiest rotation of intern year.

The biggest thing I’ve found? I have so much to learn. I often feel like a lost puppy – I do a lot of wandering around in clinic asking upper-levels where consents are kept, how to access lab values in the 25 EMR programs we use, and if we’re really sure I can give that person a refill on their Fluconazole, because holycrapmynameMDisonthatscript. I’m sure the 2nd years see me coming and battle each other for hiding spots in the equipment closet lest I ask them for 6,000th time which forms I should fill out on a pre-op hysterectomy patient. God bless their patient souls (see what I did there? heh).

Labor & Delivery call days have been fun, delivering babies and having my name go on the birth certificate is an exciting step forward from being the (extremely awesome, but typically nameless) professional placenta catcher I was in my third year of medical school. Being in charge of triaging patients has taught me a lot, but I still feel like I know close to nothing. Every upper-level and attending I’ve worked with has been extremely patient and almost all of them are eager to teach. If nothing else, after the past several weeks I am 100% convinced I chose not only the right specialty, but the perfect program for me.

Pagers still annoy me. I can’t figure out why we can write prescriptions on an iPad and it magically shows up at the pharmacy, but I still have to carry around a ridiculous piece of technology (and sometimes two or three of them) from 1970 everywhere I go. You’d think we could just get an app on our phone called “PAGER APP” and divert pages to it. I mean, really, it cannot be that hard to do. Oh well, I finally figured out how to use it and I’m slowly becoming less senile towards the little guy. At least nobody has asked me to fax anything yet.

 

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Sim labs have been great teaching tools. We’ve done some simulated complicated deliveries with Noelle (and her weird, tiny baby) which are nothing like real-life complicated deliveries, but do give you a chance to slowly and calmly think through management techniques without the nervousness. We used beef tongue for an unusually great model of perineal lacerations and hysterotomies and a couple attendings and residents worked with us learning closure techniques. We learned LEEP on some unfortunate HPV-infected summer sausages (that smelled…awesome…yah I’ll go with awesome) and the Pap Smear reps came around and gave us a nice overview of the correct technique for gathering those. All in all, I feel like these have been an awesome chance for us to practice things we are suddenly expected to know how to do.

IMG_66262013-07-01 14.45.01

 

 

 

 

 

 

 

 

 

 

So, life is busy, but good. I expect in the coming months things will only continue to get crazier and busier, but the work is fun and the people are great. My co-interns are better than I could have asked for and the upper-levels and attendings here are fabulous, as expected.

Screen shot 2013-07-15 at 5.11.53 PMInterns celebrating Jenna’s birthday!

 

Patient Stories: Cancer & The Caregiver

If you’ve been around here long you know that my love of social media goes beyond tweeting pictures of the most adorable twins on the planet and talking #meded with others in the healthcare world, it extends into the world of patients and their stories. Social media is fun, it’s interesting, and it’s a good way to interact, but more importantly social media is a teacher. I’ve learned more about how to be a compassionate doctor by listening and interacting with patients who share their stories online than I ever could have learned from a textbook.

So, when Cameron contacted me and asked if he could blog about his experiences as a caregiver for his wife who has mesothelioma I was ecstatic. The chance for my readers to hear a story about how medicine doesn’t stop at the door to their clinic – invaluable.

Let me introduce you, this is Cameron, his gorgeous Mesothelioma-butt-kicking wife Heather, and their adorable daughter, Lily.

Cameron, Lily, and Heather

And here’s what he had to say about how becoming a caregiver for his wife in her fight with Mesothelioma gave him a new perspective and mission in life:

My wife, Heather, knows that I went through a great deal after she received her diagnosis of mesothelioma. Although I briefly told her about my experience, this information will show her, and anyone else currently struggling through a similar difficult situation, more about my emotions as I cared for her.

We were blessed with the birth of our daughter Lily three months before the devastating diagnosis. Instead of being able to celebrate such a joyful event, we were instead plunged into misgiving and trouble when the doctors gave their diagnosis. From that first moment, I had trouble imagining how our family would be able to get through this time.

While I mostly wanted to take time to process my emotions, the doctors required Heather and me to begin making important decisions regarding her healthcare and treatment. This was a small portion of what I could expect over the coming months, as I would continually be needed to make more choices that were demanding.

When I was able to process my emotions, I found myself full of vexation, frustration and uncertainty. I displayed these emotions outwardly in much profanity. I was only able to curb this when I remembered that my wife and daughter needed me to be their steady support. While I certainly failed at times, I always tried to be positive for my family.

Another part of the process for me was learning how to deal with such a large number of tasks. Besides work, I also had to care for my family and pets and coordinate traveling schedules. This caused me a great deal of stress in the beginning, but I soon found that tackling one important task at a time was vital. In addition, I readily accepted the help of family and friends who graciously came to our aid during this time when I do not believe that I could have made it by myself.

The hardest time was the two months when Heather and Lily were staying in South Dakota with Heather’s parents. Heather took this time to rest after her surgery and to prepare for further mesothelioma treatments. However, I was only able to see my family once during this period.

The weekend that I visited was a snowy one. In fact, I had to wait out part of the 11-hour drive in my car as I waited for the snowplows to clear the roads. Once I arrived in South Dakota, I had a little over one day with my family before I had to return to work.

I readily admit that while the decision to be apart was hard, it was completely necessary for all of us. I needed to work while Heather needed to rest. I see this, as well as all the other exacting choices that we made, without any dissatisfaction because they were vital to Heather’s health. Through all of our struggles, Heather is still here and still healthy over six years later. I hope that our story can be a source of hope and help to those currently battling cancer, as well as those battling alongside them.

CameronBio Continue reading “Patient Stories: Cancer & The Caregiver”

Life As Of Late

This year is flying by and I am definitely enjoying being a fourth year! It’s almost surreal that I’m over 75% finished with medical school and I’m starting to see the light at the end of the tunnel. Watching our new MS1 class wander the halls in their tell-tale green Anatomy Lab scrubs makes me a bit nostalgic – it surely doesn’t feel like it’s been over 3 years since I was in their shoes!

So, what’s life been like the past few months? Let’s recap…it’s been a while since I wrote a personal post around here and we all know how I like to share my life with the internetz.

Real Life Stuff

  • We took a couple miniature vacations/weekend trips this summer.
We made a trip to Ikea in Frisco…
and did some swimming in Fort Worth.
13 Weeks Pregnant with the Elves
Then we headed to the water park for some fun in the sun!
And watched the Rangers and fireworks in Arlington.
And took my sister to visit Texas A&M.
  • My belly is growing at astronomical speed! As of today we are 21 weeks into this pregnancy, over half-way done – by Christmas we will be a family of 4 Humans + 3 Dogs.
21 Weeks Pregnant with The Elves

 

  • This past weekend we subtracted a guest room and added a nursery in our house…my Dad helped me paint painted and I posed with a roller brush.
My Dad and I Painting the Nursery

 

Medical School Stuff

  • Passed Step 2 Clinical Skills and Step 2 Clinical Knowledge. What does that mean? Basically, I don’t have to take any more exams as a medical student. NONE! As long as I pass my clerkships this year I will really, truly be an MD in May!
  • Completed 4th year rotations in Geriatrics, Pediatric Genetics, Emergency Medicine and (almost) Endocrinology.
  • Next week I start my Ob/Gyn Sub-Internship rotation. I am SO excited to see what I can learn!
  • Residency applications are nearing completion. I will submit them on September 15. Fingers crossed for some interviews!!

Coming Up

  • Stanford MedX Conference at the end of September!!
  • Hopefully lots of residency interviews…stay tuned for the hilarity that will be maternity suits for interviews.

Medical School in Denmark

Today we have a wonderful guest blogger, Andy Skovsen, with us to talk about medical education in Denmark! Andy lives in Copenhagen, but seems to have been a bit of a nomad having lived in the US a while and just returned from working in South Africa! He has also spent some time in the Danish Military and still works part-time with them. I must say, I’m a little jealous of all the great culture and scenery he seems to have experienced. Andy graduated from medical school in 2008 and has been pursuing a career in Surgery, with a particular interest in trauma and emergency medicine. He has a great blog called Doctor’s Without Filter, which is co-authored by himself and two others in Danish (Go-Go Google Translate). Andy got married last summer (Congrats!!) to a doctor who is currently pursuing a career in Cardiology and in his free time (which sounds like it might be severely limited!) he enjoys sports like skiing, mountain biking, diving, and surfing! I have to admit, I want to be friends with Andy – he sounds like tons of fun!

 

Getting In:

How old is one when they begin medical school?

Usually around 18-20. Some gain entrance through a separate set of university specific merits and tests, and are usually a couple of years older.

What exams does one have to take to get in?

Entrance is granted through application. You take finals from “gymnasium” (roughly equivalent to last year of high school and first two years of college in the US). Entrance is based on your GPA after this. Approximately 10% gain entrance through a separate quota system, which is defined by each of the 4 universities in Denmark offering a medical education and usually involves testing as wells as merits.

Is there any required pre-requisite coursework?

Certain levels of Maths, Danish, English, Physics and Chemistry are required to apply. These can be supplemented post-gymnasium graduation.

Is it a competitive occupation?

Very competitive. The number of applications far exceed the number of places. At the moment, it’s the most sought after university degree in the country.

What are you called at this stage of training?

Medical student.

 

Being In:

How long is it?

6 years. After 3 years, you are given a Bachelors diploma, which is pretty much useless unless you want to transfer to a different Masters degree.

How are the years broken down?

This varies from university to university, but generally broken into 12 semesters with the first 6 being pre-clinical, and the last 6 being clinical.

Describe your typical day.

Varies immensely for each semester/rotation. The common denominator seems to be end-of-semester exams, which increases workload and hours hitting the books to all waking hours and eliminating partying to zero.

If you choose a specialty, when do you have to decide by?

After graduation you do one year of internship, then you apply for positions in your specialty.

What are you called at this stage of training?

Medical Student

 

Getting Out:

What exams do you have to take?

Once you take your final exams from medical school, you’re pretty much done with exams.

Do most people graduate?

Students drop out of medical school mostly to switch to other degrees. I remember starting medical school, during the first lecture, we were told to “look to your right and look to your left, those two people will not be here when you graduate.” A rough estimate tells me that about 1/4 to 1/3 of starters do not finish.

When are you finally considered a “doctor?”

After passing the final year of medical school you get your diploma, then you sign the Hippocratic Oath and become a doctor.

Do you have additional training after MS or do you start working immediately?

One year of internship is mandatory. The internship is split into two 6-month positions, the first usually being in a hospital, and the second often (80%) being in primary care/family medicine. Each year is a lottery, where all graduates are assigned a random number correlating with the amount of graduates is a number internships. The graduate that received number 1 in the lottery gets first pick and so fourth. Positions are all across the (small) country. The system is perceived as unfair by many, but is not looking to be changed any time soon.

What’s the average debt for attendance?

None! Medical school is paid by the state. When attending university, you also get a small allowance (about $750/month) to live on, but books you must pay for. Living expenses are rather high, especially in Copenhagen, so many students work and may also take loans.

What are you called at this stage of training?

Doctor, Intern or Resident.

 

Being Out:

What’s the average salary?

Salary is fixed. Currently base salary is around $4,500/month on top of this you get a small remuneration for being on call, etc. Usually comes to around $5,000/month. On top of this comes taxes (50%+). Through your career your salary increases in increments.

Is the job security good?

It’s good. 100% of graduates are employed in internships. In the long run, some specialties are very difficult to get into and others you can walk right into after internship.

Can you switch specialties?

Yes, you can switch, but you start back from the first year after internship.

What are you called at this stage of training?

Doctor or Resident

 Image By Andy Skovsen | Available on Flickr

Very interesting! Thanks so much for sharing, Andy – I really enjoyed reading about medical education in your country and I know these posts are some of the most popular on Mind On Medicine, so I’m sure others enjoyed the information as well.

Other Medical Education Monday posts can be viewed here!

The Reply-All Button Ruins Lives

I like to give people the benefit of the doubt and assume that in 2012 everyone who has an email address understands the difference between a “reply-all” button and a “reply” button. Unfortunately, I am discovering this is not the case and, as such, feel it is my moral duty to inform you all that reply-all can ruin your life (and annoy the snot out of me) when used incorrectly.

So, what’s the difference?

Reply: Sends an email response to the original sender of the email.

Reply-All: Sends an email response to all 28 people who received the initial e-mail.

And what’s the problem?

Let me set up a scenario for you:

Jim sends an email to the whole company, including me, your aggravating, lunch-stealing, once-a-week showering boss, discussing all the nitty-gritty details of the meeting I’m holding Friday that will likely cut into your lunch time. He explains that we won’t be having lunch during the meeting due to recent budget cuts around the office.

You, my frustrated, overworked, underpaid, reasonable employee decide you’ll respond with a complaint to your mutually disgruntled friend, Jim, about said meeting and me, your horrible boss.

You Reply:  Message goes to Jim. Jim laughs. Jim responds. Your worries and annoyances are aired. You feel better to have vented.

You Reply-All: Message goes to Jim…and 14 other people you work with, including me, your smelly boss. You feel better to have vented. You lose your job. You are unemployed. Your dog starves to death, because you can’t afford food for him.

Conclusion:

The Reply-All Button Ruins Lives…and threatens the lives of animals…particularly when used inappropriately. It would beheave you to take note of this Public Service Announcement. Thank you for your time.

Comedic Relief – Funniest College Prank Ever

My college roommates in our apartment in 2005/2006. Pot-luck roommates and ended up living together until we graduated. Love these girls.

One night my sophomore year of college I came home from a long shift at Buffalo Wild Wings to find my room had been toilet papered by my friends and roommates. I remember being mad for some ridiculous reason (maybe because I paid for the toilet paper??), but looking back it was quite hilarious. However, nothing quite approaches the level of hilariousness presented in this video.

A group of BYU students has taken the cake with a recent Easter prank they pulled on their neighbors…you must watch this:

Original Story Here – Via KSL.com

Medical School in Indonesia

Today I’m excited to introduce to you Anna, a 22 year old medical student from Bogor, West Java province in India. She is in her last year of clinical clerkships at Universitas Pelita Harapan medical school, a bilingual (Indonesian and English) open to both local and foreign students.

Currently, Anna is undecided on a specialty, but is interested in both Neurology and Emergency Medicine. She has five more rotations before she finishes, so it will be interesting to see what she decides on! She blogs at Surreal Hours and you can catch her on Twitter @a_elissa.

She contacted me a few weeks ago asking if I was still open to having more posts in the Medical Education Monday series. I’m so thrilled that y’all find medical education in various countries as interesting as I do…it’s certainly been great to hear about all the different systems.

If you are (or someone you know is) a medical student or physician in a country not yet covered, please have them contact me! Here’s what Anna had to say about Medical School in Indonesia:

Getting In:

How old is one when they begin medical school?

We begin medical school directly after high school. However, some schools are open for students who already have an undergraduate degree, this is usually the case for foreign graduates.

What exams does one have to take to get in?

  • Public Schools: National exam called SPMB that is designed for a specific major, but is valid for any universities. This exam is not the actual entrance exam, it’s only for filtering out students who are academically eligible for a certain major, in this case for medical school. A prospective student sitting the medical school SPMB also needs to fill out a list of schools of their choice. The result of the exam is then sent out to those schools, and he will receive a notification about his acceptance. There is then another exam and an interview from each school that he has to complete and pass before being formally enrolled.
  • Private Schools: Each school has its own entrance exam, usually consisting of basic science focusing on human biology and chemistry, and an interview. Students applying for scholarship may be required to sit an additional exam.

Is there any required pre-requisite coursework?

The national high school system divides the curriculum into two major programs: Ilmu Pengetahuan Alam or IPA (Natural Sciences), and Ilmu Pengetahuan Sosial or IPS (Social Sciences). One has to do the IPA / Natural Sciences program to be eligible for medical school. If a student graduates from a foreign curriculum, like Cambridge or the International Baccalaureate (as in my case), then he must have taken at least biology, chemistry, and maths.

Is it a competitive occupation?

Very.

What are you called at this stage of training?

A high school graduate.

Being In:

How long is it?

5 years.

How are the years broken down?

  • The first 3 – 3.5 years are pre-clinical years. Using the new block system, we learn basic anatomy, physiology, biochemistry, and immunology for the first year, then system-based approach for the remaining pre-clinical years. The actual division of the organ systems depends on each school. In my school, it is musculoskeletal, cardiology, pulmonology, gastroenterology, genitourinary, endocrinology, neurology, obstetrics and gynecology, dermatology and venereology, tropical medicine, hemato-oncology, and emergency medicine.
  • Students who have completed the first 3.5 years are considered graduates already, and are granted the title “Sarjana Kedokteran” (Bachelor of Medicine). They can quit at this time and start working non-clinical jobs.
  • The last 1 to 1.5 years are clinical/clerkship years. We do 9 minor rotations and 5 major ones. They differ by duration: minors last 4-5 weeks, majors last for 10-12 weeks. Minor Rotations: Neurology, radiology, psychiatry, ophthalmology, ENT, oral medicine, dermato-venereology, anesthesiology (including critical care), and forensic medicine. Major Rotations: Surgery (including emergency medicine), internal medicine, obs/gyn, pediatrics, and public health. Upon completing the clerkship, we then graduate as Medical Doctors.

Describe your typical day.

  • Pre-clinical: Class starts at 7:30 AM. Some days start with lectures, some with PBL discussions. Labs are usually in the midday. On the last period every Friday, there is a plenary session where the PBL case study that week is discussed with an expert. The day usually ends at 3:00 PM.
  • Clinical: In my hospital, office hours start at 7:00 AM and end at 2:00 PM, while outpatient clinic starts at 9:00 AM. The first thing we do in the morning is write SOAP notes of ward patients, then wait for the attending physicians to come for the morning round. After rounds, activities vary according to department. We may have academic activities, like tutorials or case study presentations, or we may go to outpatient clinic and have academic stuff later in the day. For surgical specialties, most operations commence at around 10:00 AM, depending on the number and difficulty of the cases that day.

If you choose a specialty, when do you have to decide by?

There’s no requirement for that. Age-wise, residency programs only require applicants to be less than 30 years old by the time of entrance.

What are you called at this stage of training?

  • Pre-Clinicals Years: Medical Students.
  • Clerkship Years: Our formal name is “dokter muda” or junior physicians, but we are more often called with our colloquial names, “co-ass”, from the Dutch word co-assistant. We still use a lot of Dutch medical terms in spoken conversations.

Getting Out:

What exams do you have to take?

The law is changing as I’m typing this. There used to be no exam getting out, as each rotation in clerkship already has its own exam. However, the new bill proposes for a national board exam. It is still undecided whether the exam will be a test for theory or clinical skills, or both.

Do most people graduate?

Yes.

When are you finally considered a “doctor?”

When we have taken our Hippocratic Oath at the end of clerkship (and after the board exam, if the new bill passes).

Do you have additional training after MS or do you start working immediately?

Again, the law is under some changes. The new law requires an unpaid 1-year internship in a hospital chosen by the government. After that year, doctors can work independently.

What’s the average debt for attendance?

There is no debt, except for scholarship students. Regular students pay the full fee. Scholarship students will pay back by working for their universities or teaching hospitals immediately upon graduation for a certain period of time, usually 2n + 1.

What are you called at this stage of training?

A doctor. More formally, a general physician.

Being Out:

What’s the average salary?

Depends on where you work. The general rule is the same everywhere: it’s higher in private institutions than public ones, and is also higher in bigger cities than in rural communities.

Is the job security good?

Yes. There is a high demand for doctors throughout the country, especially outside the main islands of Java and Bali.

Can you switch specialties?

Yes, but people rarely do this.

Can you go back and choose a different specialty?

Technically, yes, as long as one has not reached the age of 30 by the time of entrance. However, I have never heard of anybody doing that.

What are you called at this stage of training?

A specialist.

I Love My Job – Medical Educator Edition

As a first year I began working alongside a Pediatrician who would become pivotal in shaping my view of doctors and specialty choice. The way she loved her job shined through every single day (and still does as I work with her in third year) and the example she was to me became key in my discovery of the importance pursuing a career in a field you love holds. She showed me how important it was to choose a specialty you are truly passionate about…partly because it benefits you, but mostly because it benefits your patients.

As I mentioned a few days ago, residency applications are looming on the horizon and, with that, comes the promise of graduation (uhh…I hope, anyway) and “the real world.” As I struggle to decide what I want to be when I grow up I find that speaking with people who truly love their job is not only incredibly eye-opening, but exceedingly inspiring to me. Last semester I began asking around to find some healthcare professionals who love what they do and are willing to tell y’all about it. I hope to build a resource here so medical students struggling with post-graduation planning can get a look into the day-to-day life of various areas of medicine and, hopefully, find a piece of themselves in one of these inspiring stories.

I started by asking Dr. Michael McKenna, pediatrician and pediatric program director at Indiana University, what he loves about his job as a medical educator and how he ended up in the position.

Here’s what he had to say…

J. Lo in The Wedding Planner, when asked why she is a wedding planner:
“Y’know, ‘Those who can’t do, teach?’ Well, those who can’t wed, plan!”

While the above quote is a common phrase, I wholeheartedly disagree. People who teach don’t do so because they can’t hack it otherwise. They do it because their passion for their field is so great they can’t help but spread their knowledge, experience and passion to others.

I am a pediatrician, but the reason that I have been asked to write for Mind on Medicine’s “I Love My Job” series is because I teach newly minted doctors how to be pediatricians.

I am a Medical Educator.

I initially thought I was going to be a Pediatric Endocrinologist because it was the only organ system that made sense to me.

But before I had a chance to go on to fellowship, I had to pay my time to the State of Indiana.

No, I wasn’t making license plates in a minimum-security correctional facility. In medical school, I participated in a tuition payment program to serve in a medically underserved area. After residency participants needed to payback their time before doing any kind of fellowship. So, Endocrinology would have to wait.

Luckily, this did not preclude me from receiving the greatest honor of my career, serving as a Chief Resident of my residency program. Most residencies have one or more Chief Residents leading during their last year. In our program, Chiefs are expected to create the schedule and call schedules for the year. They also do a great deal of problem solving. Most importantly, Chief Residents teach residents and medical students. It was this aspect of my Chief year that changed the direction of my career.

Ever since I was a kid, I considered being a teacher, but being young and foolish, I didn’t consider it “cool enough”. These thoughts came flooding back during my time as Chief, as I realized medicine and teaching could be combined into one career. Ever since, I’ve had one all-encompassing (albeit cheesy-sounding) goal… helping residents become the best pediatricians they can be.

You don’t have to be Chief or take special classes to become a medical educator. The main quality needed is passion. I encourage everyone to incorporate medical education into every career path. 

The best medical educators I know, just like the best doctors, are always adding to their knowledge base. For educators, this means attending workshops about giving feedback or creating curricula. You can even get a Master’s Degree in Medical Education.

The day-to-day flow of a medical educator varies depending on specialty and  interests. The main question of career medical educators is, “Who is paying for your time?”

In medicine, you pay for your time by seeing patients in order to bill and generate revenue. Teaching doesn’t generate any revenue. Instead, I have to convince the Chairman that I am worthy of receiving money from the budget to teach.

Medical education is a great way to keep your career exciting. Each day is different. I might be mentoring a resident, seeing patients, developing a new workshop or a myriad other tasks on my “to-do” list. More importantly, being around learners all of the time constantly exposes me to their thirst for knowledge, keeping me excited about medicine.

Many students and residents are paralyzed by the perceived gravity of choosing a career, believing that once they choose their path, they are committed to it FOREVER. That is not true. Your MD (or DO or MBBS) opens many doors. If you ever get stuck in a rut, you can always find a new adventure without up-ending your life with a new residency. Bring a learner into your practice, teach at a nearby medical center, be a mentor. Be a medical educator!

Because of the way my clinical time is set up, no one is ever going to say that Dr. McKenna is my doctor. I am sure this sounds like a sad statement. Isn’t that why most people go into medicine in the first place? Yes, on occasion I long for that, but I have something much better. If I do my job right, I will have hundreds of pediatricians that will proudly (at least I hope!) say, “Dr. McKenna taught me how to be a pediatrician.”

That is why I am a Medical Educator.

Michael McKenna is Associate Program Director of the Pediatrics Residency at Indiana University. He conducts scholarly work in the areas of social media and medicine as well as mentoring of chief residents. More importantly, he blogs about pop culture, academic medicine and history (occasionally all 3 together!) at Mamihlapinatapei (ironsalsa.wordpress.com). You can also follow him on Twitter @IronSalsa or email him at mpmckenn@ iupui.edu.

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Dogs That Eat Bugs & Spiders That Eat People

If you know me in real life (or even just read this blog or my Twitter occasionally) you’ve probably figured out that I have three dogs who are equal parts crazy and awesome (and by equal parts I mean 97.4% crazy, 2.6% awesome). They occasionally wreak havoc on the neighborhood, but once in a while will do cool things like keep me from getting a speeding ticket….or save my life when my husband isn’t home.

A bit of a back story:

I am terrified of spiders. Terrified may not be the right word, more like completely phobic of them. It’s seriously irrational and absolutely ridiculous, but I cannot control. In Psych I learned that I qualify for an actual diagnosis based on the DSM criteria for specific phobias.

One summer night after my freshman year of college I was staying at my mom’s house overnight while she was out of town or something. After I ate dinner that night I walked around the corner and into the hallway to find what can only be described as an octo-legged, girl-eating monster staring me down from the rug. My first inclination was to run for my life and scream for someone to kill it.

Then I remembered I was home by myself for at least the next 24 hours and at some point I would probably need to go down that hallway, considering it was the only way to get to the either of the bathrooms in the house…whose idea was that design?

This wasn’t just any spider, either – it was a wolf spider. If you’ve never encountered one of these satan-filled creatures be warned, they not only have the ability to jump Mr. Chow-style right at your face, but they are also not more afraid of you than you are of them…especially if you’re me.


Now, I never kill spiders if I have a choice, but if I’m the only one around I’d rather knock the sucker off on my own than let it run under a couch so it can hunt me down while I sleep, therfore Raid is a staple in my house.

Unfortunately, I was staying at my mom’s house and while she did have Raid, it was the type that’s meant for taking down wasp nests…basically it shoots chemicals out with the force of a fire hose in attempt to drown an entire nest of flying aggressors before they can attack you in buzz-filled anger.

I seriously considered going to the neighbors house and having them come help me out, but I was afraid it would disappear before they came and then I’d be forced to sleep in my car.

Anyway, I used the Wasp Raid from approximately 12 feet away to knock the creature off (along with his friend who appeared in what I can only assume was an attempt to save his buddy or claim revenge on the buddy’s murderer) and it got the job done…in fact I’m pretty sure any insect within a 30 feet radius likely encountered rolling waves of bug-killer emanating from the pond created by my weapon of choice.

I then proceeded to leave the body on the floor under a large bowl until my mom could get home and dispose of the body the next day. That night I tiptoed past the body, locked the bedroom door and slept on top of the covers with my chemical-filled fire hose in hand.

Because I was afraid it would wake back up and come for it’s revenge? I don’t know…it seemed like a good idea at the time.

Anyway:

A bit more recently I was sitting cross-legged in my desk chair reading about the Kreb’s Cycle or something equally interesting and was totally ignoring Wrigley, who was playing with what I thought was a toy right under my chair.

When he started growling I almost didn’t even hear him, he does it all the time – usually when he’s playing or trying to get my attention.

Why does he growl?

Because, by failing to appropriately channel my inner Cesar Milan, I praised him for it when he was a baby. Come on! It was just so cute. Imagine a little 2-lb baby Wrigley growling at your toes.

You know it’s cute. You would have encouraged it, too. Stop judging me.

When the growling evolved into a manic bark accompanied by insane cat-like scratching I finally glanced down to figure out what all the commotion was about. I’m sure you can guess what I found – a (slightly smaller but still rather large) creepy arachnid hanging out right where my feet would have gone had I uncrossed my legs.

It was in about four pieces by the time I looked down, which was totally gross, but I guess that’s my fault for ignoring the dog’s initial warnings of what I would call danger and I’m sure Wrigley would call total-excitement-slash-yummy-snack.

So, my 20 lb dog basically saved me from the heart attack that would’ve occurred had I set my feet down on top of that thing and since then he’s alerted me to numerous other offenders in the house.

It’s like he can sense that I need someone to protect me from them…

or he likes to eat bugs.

Either way it’s a win-win…and that’s why I no longer get onto my dog for eating bugs. 

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What’s your biggest fear?!