Moving On...to a New Blog!!!

I was perusing all my posts over the past three years. And I was thinking, "Why on earth has my blog become so negative?" Lots of frustration pouring out all over the place. Very few posts, and most of them make me feel down, not glad. So I have decided to move on to a new blog that does not focus so much on the grind of med school but on the awesomeness (I hope) of a medical career. I will keep this blog online, but I won't be posting here any longer.

The new blog is cheerful, reflects my present mood, will weather well (even if I move out of the Bay Area), and has a skull AND books on top!

Please come with me as I move over to Diary of a Future Doctor-Lady!! And may the adventures continue...

Career Musings

You may or may not have heard that I'm going to take (another) year "off" between my third and fourth year of medical school. Since I did a master's/MD, I will be doing a 6-year path through med school instead of the 4 years I was originally planning. Ouch. Instead of graduating at 26, I'll be 28. It turns out that on average, 1/3 of the rising MS4 students do this, and last year, almost 50% of the rising class decided to take a year away from their medical education. Most people did research. I am also going to do research. And career discernment, which isn't something you can put on your resume, but is super important in the crafting thereof.

At this point, I'm not really sure what I want to do with the rest of my life. I am feeling a bit behind and discouraged, largely because of my lackluster Step 1 score. I know there were extenuating circumstances, etc, but I've always been a good test-taker, so it's disappointing. I guess at our master's program, nobody ever really emphasized just how important Step 1 is in determining which career path you take -- I mean, people said, "Oh, yeah, it'll be fine," but it's really not. With my score, there are quite a few doors slamming shut. Some of them I really couldn't care less about (like radiology), but some are kind of sad (even OB/GYN and emergency medicine would be competitive for me). Of course, I for years thought about becoming a geriatrician. As far as I can tell, that path is still open to me. I also love developmental biology and genetics, so pediatrics is a natural fit. This year, I've gotten really interested in immune/rheum stuff as well, so I'm going to do research in that area to see if I want to do that clinically or whether it's only the lab work that's neat. Finally, neurology and rehab (especially spine stuff) is super interesting and expanding fast.

The other thing I've been thinking is -- it would be fine to have my Step 1 score if I were free to go anywhere and do anything. If I could literally apply to every single residency in a given specialty across the country and go to Idaho if I so chose. But obviously, that would mean that one of the best things that's ever happened to me (planning to marry B) wouldn't be happening, so I don't actually wish that. Instead, I really want to do my research and choose a specialty where my score isn't held against me too much, because I want to have a strong enough application to get in wherever B ends up also. Residency would be a long time to be apart.

Finally, I have to choose something that gets me up in the morning. Frankly, 3rd year rotations don't tell you a whole lot about what a career in a given field is like. They only give you a feel for the resident culture, which is 3-5 years of a 40+ year career (if you're lucky). You don't really get a nationwide, cross-sectional view of what it's like to be an OB versus a family doc versus a neurologist. I'm hoping to do some clinic days and shadowing during my months away, so that I do get a sense of what I'm getting myself into.

My current top 5:

1. Pediatrics
2. Child neuro
3. Rehab/spine
4. Adult neuro
5. Family or Int'l Med + geriatrics

Since applications happen in September and early applications (like Child Neuro) happen even earlier, I'm not ready to figure out what I want to do with my life and then create a good application for the 2011-2012 match year. The more I talk about the decision to take time off, the more I meet others who are doing the same thing. I'm excited. I think it will be a good move for the future, both career-wise and family-wise. And a little extra time to study for Step 2 is probably a good thing.

If you have thoughts about a gap year, pros/cons/worries/insights, please feel free to post them here!!

Surgery Shelf exam fiasco

So the surgery shelf was canceled on the day for which it was scheduled, because the surgery administrator forgot to order the exams. For real. Never has my hallowed, esteemed etc. medical school seen the like in ten years of giving these standardized national surgery shelf exams. We were, to put it gently, royally pissed off. And so the shelf was postponed, and I just took it this morning.

I would sigh a sigh of relief except -- that shelf was a monster. First of all, there was not enough time. The questions were long. And second, when people said it was a medicine shelf, they weren't kidding. Barely anything I studied was on there, and I reviewed all the exam review books. There were random questions on there that had nothing to do with any of the hundreds of topics I read about. I was hoping to do well, and now I'm even doubting if I passed it.

You know, I really wish I hadn't cried wolf all those years ago when I would say to friends or family, "I think I failed!" because back then, I knew I hadn't. These days, sometimes, it's REALLY hard to tell. I used to be a fantastic student. How do I get my groove back??!!

MY GROOVZ. I WANTZ IT! GIVE IT TO ME NOWZ!!!

Surgery

I'm currently studying for the surgery shelf, which is obviously hard. For some reason, I've been feeling less and less like writing about med school. I don't really want to air my stories about patients to the world. I can see the purpose of keeping a journal about these things, but the digestion required to make it fit for public consumption takes much more time and energy than I currently have to spend on this blog. I think I will record these beautiful and meaningful events and try to write about them when I can, but it's more important for the purposes of being a good future physician to remember them and the lessons I learned from them.

But I'm alive, and trying to balance things, and still enjoying myself in spite of it all. On bad days, it really is the patients who keep me going. The "worst" (ie most stressed, angry, saddening, or whatever) patient out there is soothing compared to dealing with the school part of it. I'm really glad I am taking a research sabbatical. It will give me time to "gather my thoughts and regain my strength." Yes, 3rd year of med school and Clueless is still very relevant. Ah, Amy Heckerling. You have no idea how much you influenced my generation.

I also need to figure out what exactly within medicine I want to do, which a prominent urologist who gave us a lecture yesterday called "absolutely the most important decision you will ever make in your careers. And soon they won't be allowing you to take a paid 2nd residency, so it may be a one-way street." This does seem like a lot of pressure. Which is why I have taken up yoga again. But that is another post for another time.

Self-Discipline

A stitch in time saves nine. Never put off for tomorrow what you can do today. Idle hands are the Devil's workshop.

I have been thinking about self-discipline. All my life, I have struggled with procrastination and absent-mindedness. Some people are born with an innate ability to plan ahead, execute that plan, and not forget anything along the way. Unfortunately, not so with me. I have a tendency toward both, which was pretty much indulged throughout my childhood. For instance, I remember when my mother was furious in 7th grade (7th!) when I didn't organize my homework the way the teacher wanted, and had marks deducted from my grade, even though the math was correct. She was furious because the math was correct and so I shouldn't have had marks off, not because I got in trouble with the teacher.

Looking back, what she, and I, failed to realize, was that the discipline of doing your homework neatly and on time is a skill that is in some ways far more important than math. And while elementary school math is easy, college math is impossible if you can't write neatly, keep your notes straight, or remember what's due when. If I forgot my books or projects at home or at school, there was always a doting parent or family member who would help me go fetch it. If I was up against the wall and hadn't done the work necessary for the day, there was always a parent willing to help me with an excuse. I thought it was funny and wonderful at the time, and once or twice it would have been. But the constant message to me was as long as you're smart, you don't need to be self-disciplined.

Don't get me wrong, I learned many important skills growing up: to dream big, to think positive and look for the silver lining, and to never give up. But this is one area in which I still need to help myself out a little bit. By definition, you cannot be nagged or coaxed into self-discipline. You must simply learn by running up against the cold, hard consequences of your decisions. As you get older, the price of doing whatever you want gets higher.

The word "discipline" has come to mean 'punishment'. But in another sense, it means 'practice'. Taken in this way, "self-discipline" actually implies "self-practice" -- the practice of exercising one's will, or self, over the mind. In many different philosophies, people have written that the mind is apart from the self. The mind is something to be trained, like any other muscle in the body :) Power over your mind allows you to make choices that are best for your true self.

For instance, let's take today:

My mind: It's so pleasant just sitting here, typing and drinking tea. Let's not start our work at all! Or we can stay home and just do a little bit at a time. There's still a lot of time until the test.

Self: You have a big exam coming up. Today is a free day, which is a wonderful opportunity to immerse yourself in the material before it becomes urgent and panicky. If you start today, January 23rd, that only gives you three more full study days before the exam, plus whatever time you can fit in during the week. You'll be able to concentrate far better in the library than at home.

Both college and medical school would have been a lot easier for me had I developed this discipline, or practice, before I left home. But I have a feeling that it's like exercise -- the more you do it, the easier it gets, and the more fun it is. If you have conquered a similar problem and have some good advice for me, please write!!

In the meantime, off I go. Wish me luck.