Sunday, November 29, 2009

Faster and Faster

I used to be more on the side of patients when it came to doctor visits, but now I'm feeling a lot worse for the doctors... We have gone through the general screening exam, which includes neuromuscular, cardiac, respiratory, gastrointestinal, HEENT and taking vitals thus far. If we are allowed to do it at our own pace, no rushing, talking sweetly to the patient, etc. it takes us about 30-40 minutes to do it at this point. We are expected to speed it up to 15 minutes. I have been able to do it all in about 15:45 minutes, but it feels so rushed as far as barking orders and telling the patient to jump and sit that I can see even more clearly how a patient would feel like a physician doesn't care about them. Unfortunately, when we're expected to cram exams into a tiny amount of's hard to do it in a way that makes a patient feel happy.

Of course, I'm betting that's where the magic of experience and bedside manner kick in. I'm going to try to practice the exam in 15 minutes but also practice my tone of voice and memorize concise, simple instructions so that I don't feel like I need to cram my words together. That, and I need to get a really good feel for the order and routine, as well as the phrases...ugh! So much to remember! We are required to say specific "lines" when we do examinations, such as "Patient is breathing easily, quietly, and regularly" or "Patient presents with no edema and is not diaphoretic or cyanotic." It really feels like being an actor/actress almost, since they really are lines.

In other news, I got a massage table, which I plan to use for massages, OMM, and exams - so that should help a lot. Also, we're focusing on hemostasis and hematological diseases at the moment - all very interesting and familiar since I worked in the laboratory for 3 years and I've seen all the lab tests before. Goal for this is to memorize the clotting cascade, the diseases, and the treatments, as well as go back over all the stuff I've already learned and try to commit it to memory.

Tuesday, November 10, 2009

Almost done with Block 2!

Just finished as much studying for Doctoring as I think will make any difference at this point. After the FOOM test on Friday, I was burnt out on studying until Sunday - so I was not very productive until then. Monday morning I practiced OMM techniques with a bunch of different classmates for about 4 hours before the practical exam, and I know for sure I aced two of the three portions. I only know because those two professors gave me feedback, and the third kept a nice poker-face the whole time - but I think I did satisfactorily at that station too. Then this morning we had our OMM written exam, where they describe positions, techniques, and segmental findings and we have to know the type of technique, what the diagnosis is, etc. We also have some "softer" portions, like history of osteopathy, particularly in California. I think they overdid it a tad on that, since our professor didn't finish the lecture on California, but should be good either way.

The Doctoring exam coming up in half an hour is going to test on portions of the screening exams - so far we have covered general, HEENT (head, eyes, ears, nose throat), Cardiovascular, Respiratory, Abdominal, and Neuromuscular. Since we're osteopaths, we also throw in a TART screen at each step, but the way it's integrated it almost feels "tacked on." The test is also going to cover Medical Jurispridence, a lecture I missed where we got to hear about all the ways we can get sued, how getting sued works, and how to try to avoid it.

We recently saw a video about Convocation too - it's essentially a DO Seminar/Convention where everyone from experts to first years goes to see different techniques, hear what's new for Osteopathy, etc. It's a little pricey, but I requested a bit more loan money this year than I needed, and it's being held at Colorado Springs resort this year, so I might as well take advantage of that. It is held on a weekend in March, but we shall see if I can attend - I might be on a vacation. Anyway, enough distracting myself - I should get focused for doctoring and then fun and relaxation for a few hours before I realize I have to start prepping for Midblock 3 that is happening in 13 days...

Saturday, November 7, 2009

Block 2 Fundamentals - Done!

Well, I finished my Block 2 exam for FOOM, but I still have two written exams (Doctoring and OMM) and a practical OMM exam. I slept through my alarm on the morning of my Block 2 test, so I didn't have time to review virology, mycology, or pathology - if I had woken up early enough I probably would have reviewed material that would have given me 3 or 4 extra correct answers on the test. Either way, I don't think this exam will affect my percentages much...unfortunately. I'll just have to try a little harder this next block! Also I took a few pictures of the campus - it was a nice sunny day, so here they are:

In other news, my LASIK is finally scheduled for good - December 4th. After that - no more contacts! Hooray! Next week after the tests should be very nice - hopefully seeing a movie or two with a classmate, Kit's coming up to visit on Thursday, and I'll have a rather relaxed weekend. Next block we will be covering diseases of the immune system including HIV/AIDS, immunopharmacology, and blood.

I feel like I've been slacking off on the USMLE First Aid book - in the sense that I have not opened it yet. I haven't been using my books enough in general. This final third block I swear I will do all the assigned readings before the lectures! I double swear! And I will cut down on the Left 4 Dead playing a little. During weekdays. If I have to wake up early. And have a short day also. Maybe.

Monday, November 2, 2009

Classes and Weekly Routine

Comparing my two blogs, I'm relieved that despite the uneven posting habits, I've essentially posted the same number of posts - go me. We're starting to get into the virus lectures, which is of course one of my main interests. I never really described our general weekly curriculum, so I'll delve into that briefly - I'm not sure how they do it at other schools, but I have a feeling we're somewhere in the middle as far as weekly hours. We also get an hour for lunch from noon to 1am.

Monday - usually a long day of lectures that set the tone for the week, lasting from 8am until 3pm-5pm. Tuesday through Thursday we have small group sessions in the morning and afternoon, and 2 hours of lecture each day. There are 3 divisions for the small group sessions, groups A, B, and C - I am group A, so I'll describe that arrangement. Tuesday we have morning small-group OMM lab, where we practice techniques, diagnostics, etc. from 8-10. From 10-12, we have lecture as a whole class. From 1-3, we sometimes have no class/independent study, it depends on how many classes are slated for that slot for those three days (2 classes, we have one afternoon off, 3 classes we have something each day). Usually it is a class-related workshop, working with new equations, concepts, etc. On Wednesday, we have morning "independent study" so we don't come in until 10, for the 10-12 whole class lecture. Our afternoon class is usually doctoring, where we practice clinical diagnostic techniques, examinations, etc. On Thursday, we have histology or pathology in the morning, and in the afternoon we either have more histology/pathology or another class-related workshop. Fridays we have lectures that may end as early as noon or as late as 5pm.

A few more observations as of late - one might think that after four years of undergraduate, some masters/higher level education, and clinical work, we would be desensitized to "sensitive" medical material, like genital warts or hypospadias. Nonetheless, I still catch a few students giggling at the mention of herpes and genital conditions. I'm sure by our second year most of the gigglers will have gotten used to it - or pelvic examinations will be extremely awkward for them (moreso than us non-gigglers).

Sunday, November 1, 2009

Back in the Swing

Well, after getting sick, dealing with the second midblock, and finally partying it up for Halloween, it is back to the grind. Lately we have been focusing on antibiotics, bacteria, etc. - which is fine by me, being interested in infectious disease. We are starting to get our clinical experiences set up - I've signed up for my first one for December 3rd. From what I hear, we get to take histories from actual patients!

Also I have touched base with a professor who is researching lysogenic bacteriophages in Salmonella, and will be starting a project to determine the actual contents of probiotics, and to determine a useful way of checking their claims. I always wondered how dry pills could contain as many active bacteria as they claim. So, either probiotics/supplements or bacteriophage research - both of which I find extremely interesting. She is also the same professor in charge of the Bolivia trip, so I have communicated to her my intent to go with them next summer. The only concern I have is that they are doing a lot of PCR and I have never actually done PCR, since in our class labs, the TAs always ran those. Not too worry - it can't take that long to learn how to do.

We have a string of exams coming up, which should be interesting. I'll be practicing OMM all next week. One of the great things about going to a DO school is that if you have a muscle/bone/joint problem, you can ask a professor to take a look, and within 5 minutes you can be feeling much better. I had some hyperextended ribs/vertebrae, and when I inhaled it compressed my nerves and sent joits around my ribcage - usually it happens transiently, but this time it stuck around the next two hours of class. I went to my adviser's office to see if he could spare a couple minutes, and when I left I was breathing painlessly - as well as having had my shoulders, neck, and arms aligned.

Also, for any possible MDs reading this, I would like to add that at Touro, our professors are very adamant about not demonizing MDs. One of our lead DO professors, every few lectures when he speaks about the development of the DO profession, always makes very clear that MDs and DOs each have their faults and that neither is wholly responsible for the clashes between the professions. I know at other DO schools there is a strong sense of rivalry, but I don't get that sense at Touro, for which I must applaud them.