Top 10: Lessons learned when on-call

1) Why stand when you can sit?
2) Why sit when you can lay down?
3) Keep hydrated.
4) Don't forget to eat.
5) Never turn your back on a woman in labor who has already had babies.
6) Try not to have patients who all have babies in the same night.
7) The OR doesn't like 4 emergency OB/GYN surgeries scheduled for the same night.
8) Offer a laboring woman either one finger or your forearm to hold onto...never your hand!
9) The lounge in the hospitals' OR is the nicest.
10) Running your butt off for 21 of a 24 hour shift makes you feel 'stoned'.

Totals for my latest call shift:
-5 vaginal deliveries
-1 C-section for breech baby
-1 emergency C-section for ruptured uterus
-1 post partum hemorrhage (with resulting emergency operation)
-1 miscarriage with severe hemorrhage (with resulting emergency operation)
-1 admitted for hyperemesis gravidarum (SEVERE case of morning sickness)

Whoa baby!

So, the past couple of weeks have been pretty busy for me. Two weeks ago, I was on call at the hospital and I watched 2 births, assisted in another 2 births, and actually delivered the next 3!!! Don't worry, the doctor was right beside me ready to step in if I f***ed up, but I think I did pretty well considering I'm still new at all this! Every baby has been a boy so far...so ladies if you want a boy, you want ME to be in the room with you!

Last week, I spent the week in another town with an OB/GYN. The first day, I was in surgery for the day. We did a C-section (my first!) and a few other gynecological procedures including an operation to re-suspend a womans bladder. It was interesting to see the types of surgeries that are done in the specialty. For the rest of the week, in the mornings we checked on the patients in the hospital and in my preceptors' office. Our cases ranged from problems with women getting pregnant, to patients getting pregnant but not wanting to stay that way, to ladies having problems with symptoms of menopause, to 'period problems', to all kinds of cancers. We were called to the emergency department at the hospital for a patient with a tubal pregnancy and another that was bleeding really bad because of an undiagnosed cervical cancer. I learned a lot during the week and am happy to say that I feel confident examining vaginas!

This week, Monday was spent in the OR at the hospital I am at. The surgeons took an 8cm ovarian cyst off a lady's ovary...no wonder she was in pain! I saw some other procedures that I hadn't see so far. Tuesday morning was in class (yawn) and the afternoon was shadowing an ultrasound technician so I could see how they did things and what they look for during OB or GYN cases. I stayed later than I was supposed to so I could see the radiologist do a procedure called a pericentesis. This is when someone has a lot of fluid in their belly. The doctor will put a catheter inside their belly to take the fluid off..he took about 4L from this patients abdomen!

This morning I spent in an infertility clinic. I learned a bit, but I didn't think it was too helpful. maybe if I spent more time there...we only saw 3 patients this morning. This afternoon, was one of my best so far! I spent it in a maternity clinic seeing patients for their prenatal appointments. I'm still new at it, but I think I'm pretty good at determining where the baby is in the belly! The doctor I worked with today was awesome...a really good teacher and really good with her patients. I hope I work with her again.

I think it's safe to say that I'd like to be involved in obstetrics in some way...question is: do I specialize in OB/GYN or do I do family practice and do deliveries?????????? Only time will tell.

Mommy...how are doctors made?

Over the last couple years, I've had to explain how doctors are trained to soooooo many people...and I think they still don't get it!!! That seems like a good place to start.

I go to a medical school that is 4 years long, as most are (some students are in 3 year programs...that's just nutbar!) Every med school has slightly different programs, but in mine, the first 2 years are primarily academic. We learn the basics of anatomy, physiology (how the body works normally), pharmacology (how the body handles medications and what meds do to the body), pathology (how disease processes work), genetics, clinical examination techniques (ie. how to examine patients), history taking (ie how to get meaningful information from patients), and have developed a rough strategy for narrowing down a diagnosis. There is a bit of patient contact during the first 2 years...just enough to keep you interested and remind you why the hell you chose to go into medicine! The doubt usually sets in during what I call 'exam season' (December and June).

Our third year consists of rotating through all the major specialties. This is the year I am in. I'm starting in Obstetrics and Gynecology but will eventually rotate through Psychiatry, Orthopedics, Anesthesia, Dermatology, Opthomology, Emergency Medicine, Surgery, Pediatrics, and Internal Medicine (fancy words for 'treating the REALLY sick/complicated people'). There is also an elective where we can do whatever we want. The purpose of this year is to try on all the specialties for size (as a future potential career), expand our medical knowledge, and learn the principles of diagnosis and treatment. This occurs in hospital and clinic settings and is where we learn how to write orders and prescriptions, work in a team with all hospital staff, learn to do procedures (ex. take biopsies, insert IVs, stitch, intubate...the list goes on and on). We also take call, which usually means shifts overnight at the hospital. If you ever see exhausted-looking people wearing short white coats with pockets stuffed to the brim and a stethoscope around our necks walking aimlessly around hospital hallways...that's us. We are officially called 'Clinical Clerks' (don't ask me why) but we call ourselves med school dorks/nerds/geeks.

Our 4th year will consist of 6 electives (whatever we want to do) with a chunk in the middle of the year for more academic work. It's an extension of third year, but with more knowledge and responsibility and with a bit of focus on narrowing down choices for a carreer. During 4th year, we in Canada apply for CaRMS (Canadian Resident Matching Service). After 4 years of medical school we will have an MD degree (and are called doctors), but will still not be able to practice medicine on our own. We still need more training as what are called Residents. The way CaRMS works is we apply for and rank what specialty and what school we want to go to for more training. For example if I wanted to be a Pediatrician, I would apply for the Peds programs at U of T, U of A, U of C, UBC, etc, etc. All the schools then interview suitable students and then rank who they want to train with them. If successful, I would be a Peds Resident. Each specialty has a different amount of residency training: Family Medicine is 2 years, Peds is 4 years, everything else is 5 years.

It takes at least 10 years to train a doctor. 4 years of a bachelors degree, 4 years of medical school, plus residency (anywhere from 2-5 years). And to sub-specialize is even more.

I haven't even mentioned the costs...don't remind me.

Let me introduce myself...

I've kept a written journal for years, but I've decided this is a better way to share my world with friends and family...and whoever else is nosy, I suppose. For those of you who don't know, I'm a Canadian female 3rd year medical student in my late 20's. I'm a 'small town girl' at heart but have lived in the 'big city' for more than 10 years so I have both perspectives. I am single, without children or pets, and live in an apartment with me, myself, and I.

I've started this blog for a few reasons:1) Keep friends and family up to date on the goings-on in my life. I am extremely busy and don't much like talking on the phone (Guess I did too much when I was a teen!)
2) An outlet. Gotta let these emotions out somehow...when I get angry or frustrated, I like to rant. Should be entertaining for you!
3) Keep a journal. So I can remember what the hell I did.
4) So I can be part of the 'cool kids' crowd...seems everyone is blogging these days!

Hope you enjoy!