Life as a 4th year medical student

I’m about to finish medical school! It’s been a long road. 2.5 years in Grenada (including Foundations) and 2 years in New York doing clinicals. Unfortunately SGU is no longer affiliated with Methodist Hospital, so I wasn’t allowed to do my 4th year rotations there. By the end of 3rd year, most the student realized that Methodist Hospital would no longer be an option for 4th year so we all ran to Brooklyn Hospital to finish our clinicals.

A lot has happened since my last post. I took Step 2 CS and Step 2 CK and fortunately I passed both! The Step 2 CS is a clinical skills exam that only takes place in certain locations throughout the US. I took mine in Chicago, but many New Yorkers easily take their’s in Philadelphia. The Step 2 CS was very similar to the OSCE’s in Grenada. I definitely think that SGU prepared us well for this exam (if only I had paid more attention during CPD). One of the most helpful things I did before Step 2 CS was find a study partner to go through all the cases in the First Aid Step 2 CS book, and practice writing notes on the official Step 2 CS site. Other than that, I felt like no other preparation was needed.

Step 2 CK was a miserable experience. Just like Step 1, I found myself double guessing all my answers and wondering if I had learned anything in the past year. After my rotations, I had about 2 weeks to study before the big day. Overall, the exam went by fast, and a lot of the material were things I learned at some point during my clinical training or in UWorld. With that being said, it was still a difficult exam that takes a lot of preparation. It’s was a huge relief to be done with exams for awhile. I found out in mid-September that I had passed Step 2 CK, and I could now prepare for THE MATCH!

I began my 4th year of med school with a Family Medicine rotation at Brooklyn Hospital. I didn’t have the opportunity to do Family Medicine during my 3rd year, and I realized if I wanted to apply to a Family Medicine residency, then I better get a letter. I started my Family Medicine rotation in the middle of September hoping that I could get a letter of recommendation ASAP. Since residency applications were due on September 15th, I knew that gave me little time before programs started reading my application. In addition, I found that many Family Medicine Programs wouldn’t even let you apply if you didn’t have a letter of recommendation from a Family Medicine physician. It seemed that my chances of getting a good letter quick were grim, so I also decided to apply to some Internal Medicine programs as a backup.

4th year is a compelete blur. All your time from October-February is spent travelling and preparing for residency. A couple weeks after applying to residency, I started getting emails for interviews. I thought about how I was going to schedule west coast interviews all at the same time, but all my planning went out the window as I found that spots get filled up fast. Overall, I decided to go to 19 interviews which in retrospect probably was way to many. I was travelling 2-3 times a week to all different places all over the US. It’s a lot of time and money (thanks parents!) My rotations during these months were easier ones as I chose rotations that would be more relaxed so I could travel to my interviews.

The interviews went by so fast. All the programs kinda mixed together after awhile. I decided to rank many places on the strength of the program (university affiliated), location, look and feel of the hospital and residents. I figured out pretty fast that I probably wouldn’t hold up very well in the snow. Some of the places I interviewed at were FREEZING. After interviews, it’s time to turn in the rank list and wait 3 weeks to see if you match. Those 3 weeks were torture. Every second I found myself thinking about whether I made a mistake somehow submitting or if I ranked the programs I liked correctly. Up until the very last minute, I didn’t know where to rank most programs since I liked so many! After 3 stressful weeks I got an email on Monday from NRMP stating I matched!

NRMP

There’s so much joy until you realize you have no idea where you matched until Friday. It’s not over yet… You spend the whole week questioning your rank list and thinking what if I get the very last program on my list! So finally Friday rolls around and I found out I matched at LSU-Shreveport Family Medicine! So I guess this California girl is moving to the South!

After all this commotion, you then realize you’re not done with medical school yet. There’s still rotations to go to and graduation to prepare for. I just finished my Radiology-Oncology rotation at Brooklyn Hospital. I learned a ton about treating cancers with RT.  It was a quick month that taught me the important of knowing the different stages of cancer and potential ways to treat each. Next, I’m finishing my time in NY in a Radiology rotation! Soon it will be time to say thank you SGU for giving me this opportunity to study medicine and make it my life! Can’t wait to move to the South and see what residency holds!

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5th term and beyond!

A LOT has happened since my last post. I successfully finished basic sciences in Grenada, took my Step 1 in August and started clinical rotations! It’s been a long ride to get to this point. I never thought I would see my last day in Grenada after 2.5 years!  5th term was a lot to handle. Not only are there rigorous courses, but there isn’t a lot of time afterwards to prepare for the USMLE Step 1. Remember to fill out all the paper work early to apply for Step 1. I didn’t realize I needed a passport sized photo for my application and ended up getting them done on the island. Another thing is there are a lot of health requirements to start clinicals such as titers and what not that needed to be done. I wish I had started those before my 5th term, because they took over a week to finish and get results.   5th term is comprised of 3 main courses: pathophys, pharmacology and introduction to clinical medicine (ICM). Of the 3, I found that pathophys was the toughest since it’s basically a course to review all the material on Step 1. This course involved a lot of reading First Aid as well as old lecture notes. It’s also worth almost the same amount of credits as path 4th term so you definitely should not slack off. Pharmacology wasn’t as tough, only because our class was curved. If not for the curve, I probably would’ve had to spend a lot more time studying. I definitely think Pharmacology was one of the most organized courses at SGU. I wish I could’ve put more effort into the course. Last but not least, ICM. This course involves weekly visits to Grenada’s  hospital. This course taught us how to interact with real patients, and taught us real examination skills. Some weeks going to the hospital was a great learning experience and then others it was a drag taking the hot bus all the way to the city. Overall, I found this class interesting, but no where compared to US hospitals. At the end of 5th term, there are 2 comprehensive exams required to graduate. The BSCE and NBME. These exams were basically easier versions of Step 1. The exams are easily passable with a bit of studying and keeping up in your courses for 5th term.

After 5th term, I decided to stay on the island for a couple more weeks to study for my Step 1. This exam is a requirement for all US residencies and to begin clinical rotations. It was probably one of the most important exams I’ve ever taken! It was a stressful 6 weeks on the island of self studying before I took my Step 1! This was probably the best decision I’ve ever made since I didn’t have to spend time flying home and looking for a place to study. It however, does get extremely lonely seeing everyone leave. Everyone has a diffemt method of studying for this exam. I found that studying First Aid was not enough for me so I used a combination of lecture notes, Kaplan videos, first aid and UWorld. Looking back, if I had to do it again, I would’ve probably spent about 80% of my time doing questions and 20% actually studying material. SGU actually does a really good job preparing students for the Step 1. I think that if I had actually retained the information I learned in the last 2.5 years it would probably have been enough to at least pass the Step 1. After 3 long weeks of waiting, I finally got my score! PASS! I could not have been more excited.

In August I started my clinical rotations in NY. SGU has a lot of different sites for clinical rotations. They let you chose your top 3 preferred states and then after that it’s based in luck. Luckily, I got my first choice hospital. Clinical rotations are so much different than basic sciences. First off, everything you learned from book goes out the window when you see a real patient. I started with a Psych rotation and was thrown into the ED on my first day. I had no idea what to do. Eventually I figured out my way around the hospital. I wasn’t expecting to like Psychiatry, but it was actually a great first rotation. I learned a lot about taking a good history, but nothing about physical exams. Each core rotation is 6 weeks unless it’s Internal Med or Surgery which are 12 weeks. At the end of each rotation, there’s a shelf exam which is basically written by the creators of Step 1. Therefore, the questions are tough, but they are curved extensively. Besides Psych, I’ve now done rotations in both Geriatrics and Internal Medicine. Geriatrics is not a core rotation, but my hospital did not have any family medicine rotations. I had a great time doing my Geriatrics rotation. It was an amazing introduction to Internal Medicine. The patients were kind and didn’t mind being questioned by a student. If not for my Geriatrics rotation, I would’ve definitely not have even considered doing Internal Med in the future. I found Internal Med to be a lot of paperwork and much less actual medicine. Most days I was requesting records from other hospitals or writing notes on the computer. The rotation varies from hospital to hospital, but I did find that it was a lot less hands on than I was expecting. Nonetheless, it was a relaxing rotation that left a lot of time for studying. I learned a lot from the attendings and residents. I’m now onto my Peds rotation, so updates to come soon!

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Term 4

It’s been awhile since I’ve written. This semester has been extremely busy with Pathology, Micro and CPD. Everyone always told me that term 4 was the hardest, but  with 3 more weeks until the end of the semester, it’s not true at all. The most difficult part of term 4 is the course load. Path is worth so many credits that no one wants to screw up. I think it’s fair to say that the Path department is pretty understanding with the amount of work they expect. A typical week consists of about 20 path slides to split among your group of 8. Everyday each student presents the slides they completed during path lab to the rest of the group. This course is pretty structured so there’s no way to screw up the general busy work. As for the other courses….. Micro is a whole different story. The class is interesting, but the Professors each have their own way of teaching the material. I’m the type of person that likes to learn everything at once so you can imagine my frustration when they constantly bring up random organisms everywhere.  There’s no real method to study for micro except to try to describe the organism and make charts. The other class I’ve been taking is CPD. This class is supposed to teach us communication techniques and proper ways to do a physical exam. I know that in the next couple of months this class will be extremely useful, but it’s 3 weeks until the end of the semester, and I’m still confused what to do every time I go to lab. In class the professors teach us how to apply our skills in lab. In lab, they expect us to remember diagnoses since term 1. It’s very confusing. I find a better way to teach this course would probably be teaching how to diagnose symptoms in patients and making differentials during class. During lab, they should be teaching us how to do clinical skills instead of just expecting us to watch YouTube videos. Also throw away all the clinical skills you do in term 1 anatomy because apparently all those skills were taught incorrectly. Besides all the conflicts with 4th term classes, I’ve learned to adapt to the pace we’re learning at. If anything, the rumors about 4th term definitely aren’t true. There’s ample time to study the material if you use lab time wisely. Other than that, there’s a lot less Bananas trips this term.

On a side note, there’s a couple things SGU decided to implement this semester to all terms. We now have MCQ clicker sessions for every class. I found these questions useful for Path and sometimes Micro, but I have no idea why we have them for CPD. We don’t even have any multiple choice exams for that class. I would appreciate if the administration would relax and do clicker sessions every other week so that the Professors can come up with questions that are more like what we’d see on the exam. All in all, the clicker sessions if anything have put so much more work on our 4th term schedule. Hopefully they change the policy by the time I get to 5th term. Another thing is, they decided to implement an 80% attendance policy for every class. That’s all I’ll say about that.

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Term 3!

Glad term 2 is over. As I learned first hand, don’t take term 2 for granted. All the classes are actually quite challenging, but I found Neuro to be quite fun. It actually seemed like we were learning something useful. Plus we got to take out the PD kit and try out all the tools. I found Physio to be the most challenging out of all the classes, but that was mainly because I had no idea what was going on. Basically everyone has like 1000s of ‘MOTO questions” that we would just do over and over until we memorized the questions and hoped they appeared in the same format on the exam….they didn’t for the final haaha. Immuno was pure memorization. I felt like by the end of it, I was saying cytokines in my sleep! Nothing to be worried about for that class as long as you watch Cells Acting Badly on Youtube before the lecture.

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Term 2!

Haven’t posted in a while because it’s been so busy around here. First term is over and I passed! To start things off, there’s a brand new building on campus! Finally SGU has built a new study hall to account for the increasing number of students. At first I was upset because it basically covers the best view on campus, but since it’s not enclosed, the view hasn’t been disturbed.

Not gonna lie, I thought this semesters was gonna be a walk in the park. I have now comes to see that all the upper termers were lying to me. After a 3 week break, I returned to the rock ready to continue relaxing. 2nd term starts with 2 simple classes, Bioethics and Community, Preventative Medicine (CPM). With these classes, basically all you need to do is attend class and you’re basically guaranteed to pass. We all took advantage of this extra free time by heading to the Concord Falls all the way on the other side of the island. I’ve never been past this city, so this was really exciting. On the way, we stopped and tried some fresh sugar cane and cocoa! Then finals came and it was time for the real classes to begin. Term 2 classes consist of Physiology, Neuroscience and Genetics/ Immunology. The good thing is, classes run early in the morning so there’s a lot more time to study ( or the class recordings are posted when you wake up) We also have a lot shorter labs! This just makes me more grateful that I’m done taking Anatomy forever!!!!!!!

So this past week, we had our first round of exams, and boy were they disappointing for most people. Each class has a set of Unifieds which basically means there’s 20 questions per subject and you get 30 minutes for that set. I think we all underestimated how fast the time goes. From what I hear, most people either ran out of time on Genetics or Physiology. Of all the exams, genetics was our class’ lowest average at 65%, but Unifieds generally aren’t representative of midterms scores. Another thing is, attendance this semester is mandatory because a lot of students struggled last semester. By now, our class is still about 650 because of all the repeaters. At 3 weeks in, classes are really picking up. There’s 4 lectures every day and less and less overlap from what I learned in foundations. On the bright side, there’s a lot more time to study all this material and explore this beautiful island!

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Concord Falls

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Modica Hall

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Halfway there!

It’s been awhile since first term started. I think everyone’s starting to understand how things work around here. Though there are some familiar subjects, the testing style in first term is completely different from foundations. In foundations, all the exams were based solely on recall; this semester, all our exams are “clinical based”. I think the hardest part about first term is just staying on top of things. There’s no one reminding you that small quizzes are due or there’s an extra lecture. Every week we have Histo lab, Anatomy lab and sometimes even Biochemistry lab. I find Histo lab to be the most helpful because I hardly ever pay attention during lecture. There’s also a lot more material in 1st term. I was pretty excited to hear that we have a full day in between each exam, but it’s definitely necessary. There isn’t really much guidance before midterms. We have unifieds which consists of 25 questions per class, but I didn’t find them to be an accurate representation of what we should expect on midterms.

Midterms went pretty well for the most part. The majority of my class passed easily. In the end, I assume probably about 50 people decelled. The best part about midterms though, is the week after. Basically we all take a whole week off to go to the beach and enjoy life again. Also, at SGU we have an event called Sandblast which is basically a huge beach/booze party. This semester, the weather was just terrible. It rained… A LOT. And even after exams, the workload has decreased significantly for now. We haven’t even had anatomy lab in awhile! I guess this weekend I’ll have even more time to do fun stuff because it’s Grenadian Thanksgiving! 4 Day weekend!!!

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My roommate and I at Sandblast!

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Red snapper at BB’s Crabback

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Fried Ice cream at Carib Sushi

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1st Term!

Well, it’s been 1 whole week in first term, and all I can say is… THANK GOD FOR FOUNDATIONS. So far, the material hasn’t been that challenging because we’re getting essentially the same slides as last semester. This semester I’m only taking 3 classes: Biochemistry, Histology and Anatomy. I can’t even imagine how difficult 1st semester would be without taking a whole semester of pre-med classes. On the first day, the professor jumped straight into superficial and deep back muscles. All the newbies were trying to figure out how to study while the foundations students felt right at ease.I hope this continues throughout the semester. I arrived back onto the island on August 9th. Since then, we’ve had a whole week of Orientation which of course, I skipped because I already know where everything is. Also It was Carnival when I arrived so everything was closed! People were going crazy every night! Kinda wish I had attended more of the festivities. Even our room was a bit crazy. It actually flooded within the first week. It’s been great living on campus this year. I get to have my own room in a 3 person suite! Definitely a step up from living in Grand Anse. It’s quite chaotic getting groceries though. The Grand Anse dorms were just across the street from the main supermarket, IGA. Now I have to take the bus over there and take a taxi home. I also have to learn to cook more meals now that I’m not living that close to edible food. I also miss not living a couple feet from the beach. Definitely gonna have to get used to taking the bus covered in sand.

One thing that does bother me though is that there’s way too many people in my classes. The buses are full, the study hall is full. THERE’S PEOPLE EVERYWHERE!! In foundations we only had about 60 students, but this class is around 800!! And even worse, everyone takes up all the seats 30 minutes before classes even start. Definitely ruining my schedule. So far our lectures have been pretty clear. I don’t think anyone knows what’s going on for labs though. Even though they gave us all an introduction to imaging, wet lab and histo labs, no one knows what’s due every week. Luckily I have the best lab times since they go in alphabetical order. We did get to try the ultrasound machine and work with the locals which was pretty cool!!
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