Gettysburg

This weekend a few of us took a quick trip to Gettysburg. I figured this would probably be the only opportunity I would take to go. Unless sometime in the future I become a history buff and want to return. I also thought it would be a shame to live this close to Gettysburg and never actually take a trip there. The town is cute, the battlefield museum was nice, and the battlefield...well that was pretty much a large plot of grass spotted with monuments so the tourist have something to look at on their drive through the battlefield (below).



We bought an audio tour which lasted 2.5 hrs - we went for the super educational one. And...well we lasted about an hour! So if anyone is coming out to visit & wants to go to Gettysburg I will happily let you borrow my CD.

update

I didn't get the chance to write about my trip to Kansas City, because I came back and started my family medicine Acting Internship. I have spent the week in the hospital with the family medicine inpatient service and....somehow most of my patients end up in the ICU. I signed up for a family medicine rotation, not an ICU rotation. I'm not complaining - it's just the way it goes with family med. It literally could be anything at any given point in time. It makes the day more interesting. You can go from seeing patients on the floor, to the ICU, and then up in labor & delivery. This next week I will be on outpatient family medicine, so hopefully my schedule will calm down a little bit.

But...as for Kansas City and my never ending quest to find a residency program. My search extends from California to Texas and all the way east to Chicago. You may be wondering why I am searching so far and wide. Well...if you remember my boyfriend, Sief - he and I are most likely going to couples match. Which means that when we enter the match for programs we are sort of a package deal. I will explain this in more detail later, but for right now when you match as a couple you usually have to apply to more residencies than if you didn't apply as a couple.
But in my search I found some great family medicine programs. I'm getting excited about the possibility of moving somewhere new and meeting new people, etc. It's also exciting that hopefully we'll end up in a bigger city - Hershey really just isn't cutting it anymore. Yeah Baltimore, DC, NY, Philly are close, but not close enough & too expensive.

Favorite programs I found? There are a few in Cali I really like, one in Salt Lake City where sometimes they "round" with their patients outside over breakfast (my kind of place), there's one in Corpus Christi that sounds pretty good (but I know that in Corpus they have giant mosquitoes that bite through jeans)! I'm continuing my residency research online and still trying to narrow my list.

I also continue to struggle with my personal statement. I've re-written and hated 3 versions of it now. Oh well..... off to enjoy the weekend!

Kansas City

This weekend is the American Academy of Family Physicians (AAFP) National Conference for Students and Residents. It's a mouthful to say. At this conference there will be many seminars and lectures given by some well-known family physicians around the country. There will also be some informative sessions dealing with "The Road to Residency" - tips on applying and interviewing, etc. The most exciting part for me is that there will be residency programs from all over the United States there. I will be able to speak with residents at residency programs from California, Oregon, etc and learn about their programs. Interacting with the residents will also help give me an idea as to whether or not I could see myself working with them and people like them in the future. This is my trip to narrow down my list of places that I will be applying for residency.

In the upcoming weeks, I am going to try and explain somewhat about the applying to residency process, the match, etc. I hope it's not too boring, but it's a confusing process and this way maybe when I'm home at Thanksgiving or I mention something in an email while talking about what I'm up to that having read some of it first will make it less confusing.

First - as many of you know I am in my 4th and final year of medical school! woohoo!!!!! I have made my decision that I want to be a family physician. The next step in my training process is to apply to a residency in family medicine. This residency will last for 3 years and my training will be specific to family medicine (even though family medicine truly is a little bit of everything). But let's say I wanted to do surgery instead - I would apply to a surgical residency and start my training in surgery next year. That residency lasts 5 years.

A resident is a doctor, but they are still "in training." Residents work under attendings (doctors who have completed residency), so all of the steps a resident takes are overseen by another doctor. But...as a resident I finally will be able to admit people to the hospital, write prescriptions, and actually start to have my own patients. Slowly as a resident you build up your independence and are actually useful. The other big perk of being a resident is that you get paid...finally! Definitely not the type of salary people think of when they hear the word doctor - try about $40,000-45,000 for working up to 80 hours per week, with close to a quarter million dollars in loans with interest to pay off. Ahhh...the life of luxury.

So right now I'm starting the process of looking into where I want to apply to residency. I'm working on my Curriculum Vitae (very similar to a resume), personal statement (which is excrutiatingly painful, because all creativity I once had has been slowly sucked out of me over the last 3 yrs), and filling out the online application. I'm just at the start of the process, but am already feeling overwhelmed with the amount of work that needs to be accomplished in the next few months.

I'm off tomorrow morning! Wish me luck & I will fill you in once I'm back in Hershey :)

Yummy quick easy recipe

Creamy Spinach Ravioli

ingredients
2 pkgs (9oz) refrigerated cheese ravioli (i used some fresh chicken, mozzerella or something ravioli's from costco)
1/2 c. philadelphia chive & onion cream cheese spread (low fat) - i used the whipped kind. (also good on carrots & cucumbers)
1 c. milk
1/4 c. Parmesan cheese
4 c. baby spinach leaves
grated peel from1 lemon
6 cherry tomatoes

cook pasta as directed

meanwhile
place cream cheese in lg skilled. add milk; cook on med heat 1-2min or until cream cheese is melted & mixture is well blended, stirring frequently,
add 1/4 c. parmesean cheese w/ spinach, dill & lemon peel, mix well

drain pasta - add to cream cheese sauce; toss to coat, serve w/ topped tomatoes & some parm

I squirted 1/2 the lemon juice into mine

Goes well with a glass of wine and a girly movie (i watched bride wars)

Still Learning Bedside Manner

A doctor or student's bedside manner is something that develops overtime. I like to think that I have a decent bedside manner most of the time. This is the type of thing where I watch others to see what I can pick up in terms of things I would like to emulate myself and also habits that I hope to not mimic. It is part of the art of medicine and also I believe has a lot to do with one's natural personality. Bedside manner is something that is constantly growing and changing. I am changing as a person, my patients are changing, and so is the situation. The key is learning to try and gauge your patients, the situation, and knowing yourself make yourself be as appropriate, comforting, and compassionate as the situation allows. A doctor has to be adaptable and know when to be a hardass about certain things in order to get across the importance of stopping smoking, for example. It's a hit or miss type of thing and I'm learning as I go along. And let me tell you sometimes it can be funny...



A lesson learned tonight in the ED.

I was checking the function of cranial nerves on a patient. Often times to check the facial nerve (cranial nerve 7) which is in charge of the facial muscles by asking the patient to either smile or show you their teeth.

Here's how the conversation went this evening:
Jen: "show me your teeth"
Patient: "I don't have any"

ocean view

I feel as if I'm standing atop a cliff with the ocean waves crashing far far below. It has taken me the past 3 years to hike up to the top of this cliff and finally I can see the beautiful horizon. This year I get to stand here, atop the cliff and enjoy the feel of the ocean breeze upon my face and the gorgeous view. I have to enjoy it, because at the end of the year I must jump. Jump into the cool blue ocean below. I can land with a crisp clean dive enveloped by the welcoming water to start a new adventure or I could belly flop...ouch.

That's sort of how I feel. I look forward to this next year excited, but truthfully I'm scared. I have none to very little control over the next stage in my life. It's very scary that next year at this point in time I can honestly tell you I have no idea where I will be. From the places I currently have on my list of residencies to apply to - I could be anywhere from as far west as San Francisco, California to as far east as Chicago, Illinois! And the only control I have is to make a list of the places that interview me and hope that it all works out.

I keep telling myself that if I end up somewhere not as close to home as I would like - it's just another 3 years and it's another new city to explore. I'm ready to be back home, though. I'm tired of living my life in 4 year chapters.

Even though I'm scared, this is the year for me to live it up! I actually get my life back this year before I become a slave to the system once again.

Family medicine

I have not been writing as much as I had hoped to recently, because I have A LOT on my plate right now in terms of things that need to be accomplished in the near future.
I have a personal statement to write, a CV to compile, a list of residency programs to narrow down where I will apply, and then fill out the application. So lets just say even though I am enjoying 4th year and relaxing some - I'm also still running around like a crazy person.
Starting my personal statement is what I have dreaded the most...and today is the day I am making myself start to write it.

I went back in my journal from when I had my family medicine rotation last July and thought I would share that entry with you now.

"So after 4 weeks in a family practice setting - could I see myself doing that for the rest of my life? I would say it is still a definite possibility. The reasons I enjoy it so much are the personal interactions, the extended relationship of knowing your patients for years, and the variety. When walking into a patient's room you truly never know what you are going to end up discussing. For example a young man came in the other day for an infected thumb wound, well before the visit was over we had a discussion about his pregnant wife and the fact that their baby failed the nuchal fold test (one of the possible tests for Down's) and the chorionic villi test came back normal. They are unsure if the nuchal test was a false positive or something else. Anyway - NOT what you would be expecting when walking into the room.

It's the trust & bond between the patient and the doc. The chance to make a difference throughout the patient's life. To be there during times of grief & there to share in their celebrations. To counsel, console, and educate your patients. Help them change behaviors for a more healthy lifestyle for the rest of their lives. I will learn from my patient's and their unique lives & backgrounds.

What do I worry about or the not so great aspects of family medicine? There is variety, but...will I get tired of hypertension, diabetes, COPD, etc? Will I be able to have a younger patient population in my practice? or do deliveries if I want to? Learning to and performing procedures is possible, but how hard is it to learn? Will I get bored? I hope & thing not, but it's possible.
Underserved, preventative, & women's health are where my interests currently lie. So much to learn & experience this next year. another exciting time is approaching - where & what will I be doing in 3 years? who knows? Anything is possible."


Well it seems it as all come full circle. Final decision is family medicine and right now I still would like to focus on women's health and preventative medicine. Lucky for me family medicine in the West is much more amenable to family docs delivering babies. :)