A Fork in the Road

The fork on EXCITEMENT ROAD by ~Hyoni on deviantART

I feel like I've just reignited the "fork in the road" dilemma. Recall that just prior to coming to med school, I did a year of a Master's in Public Health (MPH) at UM SPH. While I loved my MPH education and appreciated the perspective on health that it gave me, when I started med school I readied myself for the possibility of never being able to complete my MPH.

Then I met an infectious disease specialist who I had the privilege of shadowing (twice, ^_^). When we first met, I mentioned how I began a MPH but didn't finish. When I said I was still considering the possibility of completing my MPH, he promptly sent an email to the MPH course director here and just last Thursday I followed up and met with her.

From the outset of our meeting, the MPH director here told me that 1.) I have to finish my MPH because it's so valuable, and 2.) that I should go back to UM SPH to complete it. My MPH was in Hospital & Molecular Epidemiology (MHE) and I further specialized it with an emphasis on genetics. That degree of specialization was something that the MPH program here couldn't accommodate. She said something to the effect of, "We could give you an MPH degree here, but it'd just be a title and probably not what you want or need." So we quickly reached the consensus that it's best if I returned to UM SPH to complete my MPH. Now the bigger question is: when?

That question is the question that had been plaguing me. I have several options: take a break between M2 and M3 year to complete my MPH, take a break between M4 and intern year to complete my MPH, or get accepted to one of UM's residency programs and complete my MPH during residency and extend my residency an extra year. I rejected all those options for various reasons.

I didn't want to do it between M2 and M3 year because it would separate me from my cohort of classmates. As I'm required to do my M3 rotations at my med school, I didn't want to go into my M3 year not really knowing anyone rotating with me. It can be important, at least emotionally, to have another person you at least recognize and can commiserate with. I didn't want to do it between M4 and intern year because every doctor I spoke to, without fail, strongly recommended against it; as such, I wouldn't even consider this an option. And lastly, completing my MPH as a part of my residency and extending my residency time. This requires me to bank on getting into one of UM's residency programs, and there are no guarantees and so I feel that this option takes too great a chance.

With all these options exhausted, when could I possibly complete my MPH? My MPH credits are only good for 5 years after I disenroll from UM SPH. The MPH director then mentioned a possibility that I didn't even know existed (or thought feasible): take a break between M3 and M4 year to complete my MPH. After mulling it over, I believe this to be the best option for me, and here's why:

I would stay together with my cohort of classmates through M3 year. At that point, I might want a break from med school anyway. So returning to UM SPH to complete my final year of my MPH would be useful for preventing "burn out." Then for my M4 year, I won't even bother signing an apartment lease back near my med school. Instead, I'll do several away rotations at institutions that I would consider applying to residency programs anyway.

This options has several advantages. First, I'll be able to complete my MPH before I apply to residencies, thus giving me an "edge" on many other med students applying for the same residency programs. Second, it allows me to take a breath of sorts from med school to recoup (it's pretty nice getting breaks back, because after M2 year there are no more breaks until the end of M4 year). Third, it almost forces me to do away rotations, and everyone seems to recommend doing away rotations if at all possible. I know that if I wasn't forced to go away from med school, I probably wouldn't go through the hassle of doing away rotations.

All of this in addition to completing the MPH itself, which is again hugely valuable. Just the thought of it brings back waves of nostalgia. To walk through UM central campus again, to go to some of the restaurants and eateries that I've loved for 5 years, to walk through the Chem building, Nat Sci, the UGLi, and to GSI again! Oh how I would love to GSI again (and the accompanying tuition waiver and stipend are definitely wonderful perks!).

The thought of all this potentially working out makes me super excited! It's a win-win situation all around. Going through M1, M2, and M3 years without worry, completing my MPH, possibly not adding to my debt for a year (lol), doing away rotations during my M4 year, and getting an edge on many other med students during residency applications. It just all depends on how away rotations work my M4 year and how many away rotations I can do.

The weird thing is - if this all does work out - I could be graduating from UM SPH the same time as my youngest brother, Kevin, graduates from UM undergrad; and if my other brother, Eric, gets into med school this year, I'll be graduating from med school the same time as he graduates from med school. o_O Ah well, such is life.

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Catching Up

So, much has happened since I last blogged. I was doing good for a little bit there!

Back in January a highlight for me was translating for a Chinese woman at the Saturday Free Clinic I volunteered at (along with almost everyone else in my class, lol). I wrote a blog post (here) on my health collaboration blog, Healix. I won't re-write it all here, so go over and read it there! :-P

About 2 weeks ago I had my first block of exams for the semester. After the last exam, my anatomy lab group (Team Dendrite Storm, formerly known as Table 6) went out for breakfast since we all had the early exam time. It was a nice way to wrap up a stressful week of exams. It was also nice knowing we were done while half our class was taking the later exam time.

We went to a local bar place that apparently had pretty good breakfast (and they did). I had a peach mimosa, which was delicious! I didn't even know what they were until then. It was really nice eating breakfast, drinking alcohol in the middle of the day (lol), and chatting with the old labmates. It had been a while since all 5 of us sat down to chat. Usually 3-4 of us would sit with each other during lunch once a week or so.

Last Sunday it was Valentine's Day (aka, Single's Awareness Day) and Chinese New Year. Andrew, Howie, and my roommate, Ang, went out to lunch at a Chinese restaurant that the M2s said served the most authentic Chinese food in town. My roommate was driving back from home, so we met him at the restaurant. We got 3 dishes - the names of which elude me (sadly) - that we totally devoured, lol. It was alright, but I've definitely had much better before in undergrad and elsewhere. Ah, nostalgia . . .

So it's now the Year of the Tiger, my year. Meaning I'll be 24 this year, booo. I'm hoping for good things, though I sliced my right thumb while cleaning a cheese grater (I'm okay! It's pretty much all healed now) so that can't be a great sign. How embarrassing - I'm going to take that as a sign not to go into surgery in the future. Well, at least I made rum cake and it was delicious! I gave a piece to each of my labmates, and my roommate had a few pieces as well.

Anyway, as we say: 新年快乐，恭喜发财，身体健康！

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Pediatrics Skills Workshop

Through one of the student groups, the Pediatrics Interest Group (PIG), I went to a pediatrics skills workshop for M1s and M2s. There were about 30-40 students there total, and we were divided into smaller groups to rotate through several stations.

My first station was a well-child physical check-up. Two pediatricians brought in their kids for us to learn/practice check-ups on. They were such good sports about it (I don't think I would've been such a good sport unless bribed, hmm . . .). One kid was 4-years-old and he was seriously one of the cutest and most adorable kids ever! When his mom was demonstrating the physical on him, she asked, "What's that spot on your neck?" And he said, "It's my special spot," referring to a dime-sized birthmark on his neck. That was precious; he reminds me of my little cousin.

Alas, I didn't get a chance to play with the 4-year-old. The kid I worked with was 7-years-old. It's all good. After the pediatrician finished demonstrating on him, she asked him to pick who got to go first to examine him. And he chose me! ^_^ In general, you do a physical exam from head to toe. So I kinda massaged his head and neck to make sure everything was fine, no weird bumps or massive lymph nodes, then I listened to heart and lung sounds. I'm not sure exactly what I'm listening to because we haven't formally learned yet, but it's all good. Then I got to listen to bowel sounds and then my favorite, the liver scratch test. So with the liver scratch test, you put your stethoscope where you know the liver is. Then you lightly scratch the stomach closer and closer towards the liver until you can hear the scratching sound. Once you hear the scratching sound, you've found the inferior (lower) border of the liver. Pretty cool! I took someone's hammer and did the knee reflex . . . on myself - that was fun.

After that, we went to the immunization session where we learned how to give injections into muscle and subcutaneously. Ugh, I had issues getting rid of bubbles in the syringe - they just wouldn't float and go away!! It was pretty bad when the pediatrician at that station laughed at my incompetence with needles, lol. I think this is a sign that I shouldn't be giving injections to anyone (at very least, not in the near future).

Then the last station was the airways station. Personally this was my favorite one. We were shown how to use a laryngoscope to intubate (stick a breathing tube down the trachea) the airways on a child dummy. When I first put on the air mask, the pediatrician noticed how I was holding it wrong and remarked how I must've played the piano. o_O She said she used to play piano for many years, and that I was the first person to have held the air mask the way I did. Now, all laryngoscopes are left-handed tools, so I was excited since I'm left-handed; so was the pediatrician, so we were both quite excited. ^_^ It was also funny watching the right-handed people use the scope wrong before being corrected. Fail, lol!

Lastly, some of us returned to the first station that we had missed. It was doing a well-baby check on a SimBaby (a fake simulation baby). The SimBaby is really cool in that it can simulate different heart sounds, lung sounds, cries, pulses, can turn cyanotic (blue), and can even seizure. When we heard that, Keli - from the anatomy lab table across from me - and I exclaimed at once, "Omg, it has a seizure button?!" Let me say, seeing a seizing fake baby is kind of funny. But, if you mentally transpose that seizing onto a real baby, I think that'd be scary as hell. We thought it'd be really mean if, during some clinical test, someone pushed the seizure button while you were working on the SimBaby, because then it becomes an "Oh shit!" moment.

All in all, this was totally the highlight of my day. Keli and I spent some time just staring at the kids because they were so cute!!

Backlog: 12-01-09

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The Spirit Catches and You Fall Down

So it seems I'm failing at this "post weekly" thing. Hopefully this will be the first step towards remedying that. Anyway, you'll see at the bottom of some posts that say "Backlog: date" in red, indicating when that event actually occurred (and not when I posted it here).

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In undergrad, I took an amazing course called "Anthrcul 344: Medical Anthropology." One of the books we were required to read was The Spirit Catches You and You Fall Down by Anne Fadiman. It's about an epileptic Hmong girl and the narration of her story from the worldviews of both her parents and her doctors.

In early November 2009, Anne Fadiman came to give a guest lecture at my med school! Of course I had RSVP'd for this like a month in advance - and the auditorium hall was packed! I mean, how could I miss the opportunity to meet the author of a book that captured the beginning of a cultural shift within the medical profession? How could I miss an opportunity to hear what pearls of wisdom I may gain from this lecture, especially as I'm on the Hmong Health Education Program (HHEP) committee here? How could I, as a med student, not sit in on a lecture so relevant to cultural competency to aid me in better caring for a diverse patient population in the future (especially since cultural issues largely aren't discussed at length throughout medical training)?

It was a great lecture. She was more down-to-earth than I had envisioned. She discussed the conflict that could occur between two cultures due to mis-communications. Indeed, there is a medical culture that contains within it almost everything you'd expect of a culture - it has its own hierarchy, it's own rules, it's own language, it's own special clothes, it's own rituals, and it's own worldview. One thing she said that will stick in my mind is the idea of a Venn diagram of patient-physician communication. There is always overlap, however small. Sometimes the patient, sometimes the doctor, often both, must venture to the periphery of their circles into the area where the two circles overlap - to where there is common ground between patient and doctor. This overlap is (apparently) called the "lune," and we must seek it as both patients and doctors to promote maximal outcome.

Afterwards, I had the luck (and patience) to have her sign my book! Okay, I actually left my original copy back home in Michigan. But an M4 (incidentally the M4 who started the HHEP) gave me a free copy of her book for the signing, so now I have 2 books and one of them has her autograph!! She drew that Venn diagram in my book, reminding me to find the lune. I also got to take a picture with her. This must be the first time I was so close to a celebrity, lol!

Me, Anne Fadiman, and Jenny (fellow M1, also a UM alum)

Her work is well-known in medical anthropology and in the medical community. To think that a journalist would have such a profound effect on the way physicians, bioethicists, and anthropologists would view cultural differences within medicine and how those differences impact healthcare - sometimes for better and sometimes for worse.

Backlog: 11-02-09

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Happy New Year!

end of the line by *Blepharopsis on deviantART

A farewell to 2009 as it's 2010!! :-D

There isn't much to this post, just a few things to mention to welcome the new year - a few resolutions to make with respect to this blog.

1. Post more (preferably weekly).

2. Take more pictures, so I can post more pictures.

3. Fully catch up with the backlog of posts I should've made by now.

So to everyone who reads (the few who do), Happy New Year!!

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1/8 of a Doctor

In a way, it's almost difficult to believe that a semester of med school is already behind me, that I'm already "1/8 of a doctor." Thinking that way, it all feels so real. It's been such a whirlwind of a semester that I haven't really felt the time to chronicle it all. But don't worry, I have some stuff written down somewhere - I just have to transpose them into blog posts.

Earlier today I was talking with a friend of mine, James, who I've known since elementary school. He's in his first year of dental school at UM-Ann Arbor right now. He was updating me on some other people from our hometown that he still communicates/hangs out with. Pete and Mike Z are in med school at MSU now, and Mike B will be starting med school at MSU next year. We're all making it, somehow. Though we're scattered, though we're in different places with different lives, we all still made it to where we wanted.

My dad thought this was impressive, our little soccer team from way back (I was on a soccer team with James, Mike B, and Mike Z in 4th grade). Thinking on this, I'm proud that we've all achieved so much, that none of us gave up. I would be ecstatic to one day call these old friends my colleagues.

On a tangent, yesterday I met with my friend, Jared, for a late lunch/early dinner. He was my next-door neighbor for about 7-8 years. For a long time, I considered him my best friend and I still consider him one of my closest friends. He graduated last year with his degrees in communications and film studies (I believe). He wants to go into the film industry and one day be a movie director. He's really good and passionate at what he does, one of the most creative people I know, so I hope he catches a break and makes it out of this economy unscathed. But even he hasn't given up on his dreams and is still working towards them.

So until next time, let nothing stand in between you and your dreams, keep at it and bring on the day.

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You Know You're a Med Student When . . .

. . . you're able to eat lunch and study cross-sections of the male pelvis without giving a second thought about it. In retrospect, this is somewhat disturbing. o_O

3 more exams to go and then this semester's done, and I'll be 1/8 of a doctor! My next exam is in about an hour, but it shouldn't be too bad.

Motivation at this time in the semester is at an all time low. As some of my labmates have said, "Apathy has set in. I don't even care, I just want to be done. Not even the fear of doing poorly on an exam phases me anymore." A few days ago I was procrastinating on Facebook. A friend linked me to the following YouTube vids:

U of Pitt Med School: Lord of the Rings parody 1

I couldn't help but laugh when I watched it. It's soooo bad that it's hilarious. It was particularly apt when "Gandalf" declares "You shall not pass!" to a med student who accosts him. Here's a brief excerpt of the beginning:

"It began with the forging of the great bling-blings. 3 were given to the anesthesiologists, fairest, most rested of all physicians. 7 were given to the renal lords, great managers of electrolytes and craftsmen of the Foley. And 9, 9 were given to the administration, who above all else desired power and research."

U of Pitt Med School: Lord of the Rings parody 2

Short excerpt from it here:

". . . There is a union now, between the two biomedical science towers. BST1, fortress of UPMC research; and BST2, stronghold of cheap foreign labor. And now a third tower rises, a third BST constructed solely to hoard NIH funding."

Needless to say, I'm amused and impressed at the effort and time that must've went into producing such a work. I wonder how those med students carved out enough time to produce it all! Sounds like a challenge.

Okay, back to studying for my next exam. Eep!!

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