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.

 

2013-06-26 14.20.41

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”

Why Do You Blog?

The past week I’ve been meandering down the interview trail hoping to avoid death by dysentery along the way…ugh…wait…wrong trail.

Anyhow, I really have been traveling around Central Texas the past week for residency interviews and along the way the most commonly asked question has been:

“Why exactly do you blog?”

Most often the question has been posed with genuine interest and good intentions, but it has been occasionally paired with a single raised eyebrow and skeptical tone. Both reactions I understand and both are great reasons for me to address the question here. Would it be appropriate to refer someone to a URL mid-interview?

No? Oops…maybe I really have been in the blogosphere too long.

So, here are the 6 best reasons I can come up with on this half-cup of coffee I’ve had:

#1: I enjoy it.

I initially started writing in this blog 2 years ago (holy wow, have I really been typing random rants and information for two full years? You people are so tolerant.) because I felt like medical school had sucked the creativity out of me. I can’t paint or draw (except those awesome stick figures cursed with Streptococcus agalactiae and Pseudomonas), so naturally blogging was my only option.

#2: Before medical school I worried…about work-life balance, about studying, about family.

I feel like I have a perspective to share that would’ve given me hope as a pre-med. I wanted to write about whatever we might sit down and talk about over coffee. I wanted to show that a work-life balance was not impossible for a woman in medicine and I wanted to share my experiences. Everyone doesn’t go to medical school, but a lot of people seem to be genuinely interested in our experiences here, particularly those considering a career in medicine. This feeling to share the possibility of balance in medicine became even more urgent after seeing that everyone was not promoting the fact that it is possible.

#3: Our patients are online…and they have so much to teach us.

I feel like I’ve now written ad nauseam about the utility of hearing people’s stories…feel free to hop on over to “Following Patients On Twitter…” or “What Medical School Doesn’t Teach Us” for my take on learning from patients online.

#4: Our pateints are online…and they have a right to reliable information.

We have this unique opportunity to share information on things we are passionate about and know to be evidenced-based, like flu shots and how they’re safe in pregnancy or the fact that endometriosis is related to infertility. Though I don’t blog in this manner too often at this point in my career, I do plan to share more health information in the future (you know…when I’m really a doctor and stuff).

The bottom line is our patients are going online to find their health information and, in my eyes (and the eyes of some awesome health bloggers like SeattleMamaDoc) that means we have a responsibility to be online with them.

#5: It’s a fun challenge.

Make no mistake, friends – maintaining a blog is no easy feat. It’s a fun and interesting endeavor, but it does take some time and patience. I’ve enjoyed seeing Mind On Med evolve into what it is today and I’m excited to see where it’s headed in the future. I love the challenge of putting my thoughts into words and of designing and orchestrating the back end of the blog. It’s exciting to see what posts get a lot of chatter on the Twitters (usually not the posts I expect) and it’s fun to hear others opinions on what I have to say.

#6: I get to learn from people I never would’ve met if I wasn’t online.

I’ve interacted with people from more countries than I can count, specifically through the Medical Education Monday series. People from all over the world have taught me what it’s like to train to be a physician in their country and I’ve had the opportunity to share it with y’all. I’ve also had the chance to meet (or “meet”) medical students, doctors, and other providers from around the US and learn about how medicine is practiced in different parts of our country. These are not conversations I would have had without my involvement in social media and I think there’s a lot to be said for a tool that makes it so easy for us to step outside of our little bubbles…and comfort zones!

Why are you involved in social media and/or blogging…as a patient, provider, or student? I’m interested to hear what keeps you coming back to the wonderful web-world every day.

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!

Oh Hello, Fourth Year…

I’ve finally buckled down and started studying for Step 2 CS, the third of four USMLE “Step” exams we have to take to be a fully licensed physician. So far I’d say it’s going as well as can be expected…

I plan on taking the test at the end of June and having a week off before fourth year starts.

On that note, holy wow – when did fourth year become weeks away? Our fourth years have been doctors for 2 weeks now, which makes my class the next in line for graduation.

While we’re on the subject of graduation, let’s talk about something I saw while doing a little perusing on Pinterest today (you know…while I was…studying…):

Medical School Graduate Gifts 

Now, I’m sure this is a great blog (actually, I’m not sure seeing as I can’t read a lick of Turkish, but we’ll give them the benefit of the doubt), but they have totally missed the mark on this one.

Let’s put it this way, do not buy any of that crap for your med school graduate. Just don’t. 

Actually, there are some adorably decorated cookies or something on there as well. I’m pretty sure anyone who isn’t diabetic or lactose intolerant can appreciate some delicious iced sugar cookies, so that one I’ll make an exception for…you can buy them cookies.

But please forego the X-Ray iPhone cover, Caduceus tie and super creepy doctor trophy.

Along the same lines, I’d probably stay away from stethoscopes, speculums and pen lights.

If you feel so compelled as to buy your medical school graduate something, take advice from this more appropriate Yahoo article and go with a something useful – like a Hep B vaccinated house keeper to clean their house (which likely still has dirty anatomy scrubs and scalpels laying in the back of a closet somewhere) or money to put towards the outrageous debt they’ve become blissfully married to over the past four years.

Or a car, that’d be a nice gift, too.

But seriously, a Starbucks gift card is probably your best bet for winning over your future intern.

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