Prelude to "The Mind of an Examining Med Student - The Sequel"

Above: A Dominican kid climbing in the Salybia territory.
You'll find me climbing trees after my exam. Keep your eye out.

I never thought that I'd write again before my exam, but...
I'm in need of a break.

Here's why.

I think that another med student on a forum put studying for the big exam well... It's like running a marathon. Practice. Practice. Practice. So, out there, several studying-aid companies offer practice exams that are only 4 hours long, and there's exams that are also more like the real thing, about 8 hours long.

Well ... I took the 8 hour practice exam today.

As I took my exam in a deep corner of the library, stuck in a cubicle to separate myself from the rest of the world... I tried to simulate what the big day in a couple days would be like. Let me tell you, that the exam threw my mind left and right. At a point, I had no idea how I was doing. As much as every question is "mutually exclusive" from another in terms of content, I felt my confidence wane left and right, as one question that I was unsure about, totally made me doubt myself on a question I would typically be sure about.

And then... after all that, my reward: a number. My brain felt fried, cooked, well-done, over-easy, scrambled, and dipped in Tabasco all at once, but it did feel good to be done.

I think that's exactly the way that my exam will go on Tuesday (other than the number actually coming six weeks later). But... there's 5 days left to study, and here's the dash to the finish to making my score the best it possibly can.

It's game time.

Almost There.

Above: A Dominican Rainbow... so much better than reading pages of text. Spring 2008.

I'M STILL ALIVE...
I THINK?

The days are flying by, sometimes to the point where I the only thing reminding me of the date is the monday $1 special at the Caribou Coffee(s) I hit up. I moved my test date back to the 28th, but seeing how my progress is coming along (if there is one), I'm glad I did. However, as tempted as I am to keep pushing it back, I have to remember... I can't keep the test waiting forever. So... 28th, Regis, is my final answer.

It's me, my "bible," and a laptop, against the NBME in just a few days.

I'm still blogging, and I'll get y'all updated on what its been like these last couple of weeks (trust me, my nomadic travels of studying have taken me to some interesting experiences). This was just to let y'all know I'm still kicking. So thanks for keeping up with reading, for your support, and... stay tuned. We're almost there.

For now, its back to the books.

Two IMGers, Two Different Perspectives

Above: A view of the valleys of Dominica from Horseback Ridge.

12:45 PM. My typical lunch rush. I'm usually the type of person who schedules his lunch to avoid the lunch rush that occurs (I always thought it was a stereotype to head out for lunch at 1:00 instead of everybody else who leaves about 12:00 from their offices). However, I started my blog entry in the wrong place (I just ate Taco Bell, so it must be the food that's giving me coma)....

12:00 PM. Everyone else's lunch rush. I'm dashing between my First Aid Book and my USMLE QBank, trying to make connections for my upcoming exam (which by the way has been set on the 24th of this month, so wish me luck!). With my table of four at the library, I was taking up a lot of space on it, and this man comes in, trying to find a table. The man seemed to be about middle-aged and from the middle east. He pulls out the chair, and with simple enough body language (I had my headphones on, listening to Ramsey Lewis), I nodded to give permission to take a seat. As soon as he smiled back, I couldn't help but noticing a USMLE First Aid for Step 2 CS in his hands.

Okay, now its 12:45 PM. I see the man look like he was about to head home: he was putting together the gradually widening mess of papers that grew around his First Aid book, and I broke the ice...

Hey, are you starting studying for Step 2?, I asked him.

He nodded back to me, and also let me know he couldn't help but notice the Step 1 book in my hands, saying Step 1, I pass. Step 2, I think is hinderance for International Medical Graduate. He told me the whole story of his pathway with the ECFMG, as a foreign medical graduate, and how he now has to take the Step 2 again. I then told him that I also was part of the ECFMG as a medical student, and pointed right to the cover of my book: USMLE Step 1, it says in giant white sans serif font.

(Let's back up a step. As a Ross Medical Student, I'm a part of the ECFMG (spelled out, the Educational Commission for Foreign Medical Graduates). This is the sponsoring organization of Foreign Medical Graduates, such as myself from the Caribbean, but also from other countries, such as the middle east, where this gentleman was from.)

He then replied... I notice you speak good English. I smiled a little and then said, I was born here. After sharing a few more bits about myself, I learned the man was about to take his important exam for his career at about the same time that I was about to take the most important exam of my life. I then wished him good luck and told him I will see you in the library quite frequently. After he nodded with a smile, I packed up my stuff and I was off to lunch.

Apparently he wasn't off to lunch: he was about to duke it out with his books for a few more hours...

---

As simple of a conversation that was, it made me take a look again at where exactly I fit in the whole realm of medical students for the United States. We've got the U.S. Medical Graduates, and then the International Medical graduates (IMGs... like the middle-eastern gentlemen). As an IMG in the Caribbean, I forget that there's IMGs from other countries trying to find their medical niche in the states, but combatting battles such as language barriers and medical technique differences. These are differences that the Carribbean schools have worked hard to minimize, something I am grateful for.

However, although we have differences as a very diverse group of Truly foreign IMGs and Natural US Citizen IMGs, I believe we're all in this together, all finding our way to work for improving healthcare and for a decent living in the United States. And that realization on this July 4 weekend has brought a smile to my face.

Shortie: How I Truly Blog

"HOW EXACTLY DO YOU BLOG?"

... is a question I have been asked by some of my readers. Well, here's a true screenshot of how I get my uploads onto Blogger. For more, click on the image.

(And yes, I do turn on my Doogie Howser, M.D. Theme music as I type).

The Iced Coffee Property

Above: A motivational graphic provided courtesy, Dr. James F. Catroppo, Ross University.

Becoming a doctor requires a lot of sacrifices... time... effort... but the most significant sacrifice of all was brought up by a late New York Times article...

"... A TEMPORARY LOSS
OF THE SENSE OF SELF."

We'll get to that in a second.

Saturday. I need to take breaks. Some of the latest research has said that taking breaks is actually quintessential to remembering and organizing material (the brain does some subconscious file-sorting thing). Or, sometimes I could just be using a break to push back studying the next 70 psych drugs I need to memorize. So, I have one of three choices:

1) Stand up, grab some random book on the shelf that looks interesting, and read it.
2) Sit at my computer and Facebook and Gchat away.
3) Stare at a nearby window and start daydreaming about being outside.

On Saturday Night, I was at one of my local Starbucks, so #1 really isn't an option, and #3 was already next to me (the Starbucks next to me has some amazingly giganormous windows), so #2 was up my alley. After strumming along, I notice that my friend Cathy posted up an article from the New York Times, with the following title: Taking Time for the Self on the Path to Becoming a Doctor.

I started to read, getting the main gist of the article about the sacrifice and how us medical students embrace that sacrifice to have this sense of disconnect between our professional and our personal lives. Let's back it up a step, and put it in less technical terms. The article acknowledges through a John Hopkins University School of Medicine research study that although medicine is a time and resource demanding job, finding that appropriate time to spend with family, enjoying hobbies, and enjoying time with self, will lead to less burnout in the future.

(The article put it dramatically with the sacrifice as stated above... LOSING MYSELF? I CAN'T LOSE MYSELF!)

I learned that disconnect between was a horrible thing back in Undergrad. My friend Neal taught me that I need to be in touch with my personal self, by doing a lot of the things the Johns Hopkins' study provided and by spending that quality time with me. However, through the Illinois Leadership Center, I also learned that introducing personality and embracing a job as a "hobby" of one's own allows for a gratifying crossover between the two seemingly separate worlds. I think that both are critical for maintaining my morale.

When I was done, I looked up and there was a perfect example of how to accomplish some of this... right in front of me.

Sunday Night. I go to many coffeehouses in my area. There's some with free wi-fi, some with comfy leather chairs, others that serve time-saving lunch and dinner, and even some with all of the above. Like I said before, I can't study at home. However, this one Starbucks near my house has one characteristic that all the other coffeehouses, even other Starbucks, didn't have.

I'm observing one of the baristas, Adam, and how he interacts daily with customers, such as myself:

"Hey, how you doing today?"
"Great! How are you doing?"
"Doing well. What can I get you started with today?"
[Insert customized Starbucks order here]
"What are you guys up to tonight?"

And through this, he started a conversation learning a few things about what people get to do on a staurday night, and all with a genuine smile that says, I'm enjoying my job. I've seen him have a great dialogue on race and the suburbs with several people who just walked in, and even talk about computers with a guy who set up his own office in the corner of the shop. And on Sunday night, he came and talked to me about medical school. As I kept watching, I felt that same aura of the rewards he was reaping through simply talking; it was that enjoyment of getting to know people.

Don't get me wrong though, he was still getting his job done (and well, may I say), cleaning up floors at appropriate intervals, taking customers up as they were walking in the door (even mid-conversation), and even putting bags of coffee on the shelf appropriately. His interactions with his co-workers were also noteworthy (with Adam and Chaz at the counter, it can get quite entertaining).

You know, he could easly be a Barista who:

1) Did his job, day in and day out, not caring about the interactions with his customer. (Burnout in the forseeable future, no?)
2) Talked and talked, but never did anything for his job. (Just a talker, not a doer.)

But he was neither. He did something what many doctors can't do (combine doing their job while enjoying learning from their customers)... in a coffeeshop. And thus, with this, I name the following The Iced Coffee Property.*

"To live every day of my life with medicine, a day I don't learn just more about the science itself, but to also enjoy learning from the people who I take care of everyday, not just about medicine, but about the fulfilling lives they live. And to encourage them to live their life to their fullest, through encouragement and through allowing my personality to penetrate the job."

And there, folks, is my hobby, my way of envisioning crossing my personal and my professional life... a way to make sure that I live my love for medicine, while satisfying my thirst for always learning something new. For those of you who struggle with the idea that medicine is a burnout field, go grab some iced coffee. Then you'll see.

Source: The New York Times.

*Named after my regular item on the menu: A grande iced coffee with nonfat milk, and sugar-free vanilla sweetner. I have to watch my calories you know.

Blue Collar, Blue Scrubs

Above: Michael Collins, author of the 2009 book Blue Collar, Blue Scrubs.

"BELIEVE IN
THE SYSTEM."

I needed some inspiration... but we'll get to that in a second.

Two weeks ago. Just past nine in the morning, central standard time, I'm walking up to my standard desk at a local library, and oddly enough, a plastic placard was standing on it. I knew it wasn't there yesterday, but my mind was eerily perplexed why of all desks, my desk, had to have a placard on it. After laying down my bookbag on the floor, my eyes zipped right to the title heading the advertisement.

"A Night with Dr. Michael J. Collins, M.D."

Doctor coming to speak? At first I thought, meh. Well, I kept reading the mysterious placard for more... It was then I learned he was a construction worker, then turned medical student, then turned Mayo Clinic resident, into a distinguished orthopedic surgeon. He was there to promote his new book, Blue Collar Blue Scrubs, a story about his experiences before and during medical school, a transition from working in construction to medicine.

Whoa, I thought. Mind you, at this point I've been days into studying for the boards. The books were starting to get to me... I needed some inspiration to kick me back into gear.

So, I signed up.

Last night. As usual, things never go as expected. I always thought 15 minutes to my library would be just enough time to get there (it usually takes me five). Unfortunately, storms in the area, and an accident down the road, almost made me tardy for something I was really excited to go to. However, as soon as I got into the library's meeting room, dripping wet from a failed dry-dash across the parking lot, something surprised me about the audience.

Not a single med student.

In fact, I probably was the only patron under probably about the age of forty in the room. I sat in the back row, and patiently waited for Dr. Collins to make his entrance, starting to wonder if this was going to be a presentation that would be exactly tailored to me. I have material to study, my time is quite a commodity right now.

It turned out to be a well-spent 45 minutes in that room. My eyes were glazing up, watching him as he read a few passages about his experiences from transitioning from construction work into medicine, and then as he lived a life that... well was quite similar to one that I'm leading right now. Here's a few highlights & quotes:

---

He said: "It's easy to fall into something and just drift along."
It's so true. Collins was referring to him choosing to go into construction initially, and enjoying it. See, it wasn't until he had an "epiphany" wondering how he could do something useful and good with his life that he started thinking about the medical field. To me, I saw this quote as referring to my tendency to believe its just easy to pass exams, and be satisified with just passing. I'm just drifting along medical school... but to improve, there's gotta be a challenge: the academic challenge to get out of the rut of just passing.

"Who wants a 25 year old beer guzzler in their medical school?"
Collins was referring to his doubts about getting into medical school when the idea came along. He overcame that doubt to get on the track of where he is now. Quite, quite impressive.

"Work isn't painful, it's rewarding."
So true... us med students gotta remember what we're here for, and it'll remind us that the work that we put toward it is all worthwhile.

"If you love enough and care enough, can't we get through the obstacles that get in our way?"
Sometimes I end up thinking like this if things don't work out. However, I'm glad that I'm not the only one pulling up those doubts sometimes. With the rigor of medical school, its hard to see sometimes when the obstacles end, and it goes back to one of the themes of Collins' book: Hard work results in accomplishments.

"Believe in the system."
During the question and answer session, I raised my hand. Upon his eye contact, signalling that I could ask my question, words came flying out of my mouth... "Understanding that a humanitarian drive called you toward medicine, when you were in the first years of medical school, faced with the loads of scientific and non-human seeming information, how did you get through it all?" After a deep pause, Collins said he didn't like the first years of medical school and compared it to a kid in the library carrying 30 books in his hands (so true). But he said that believing in medical education carrying students through is what got him through. I'm thinking about finally putting some trust into it too, even though it may be hard at times to do so.

"There is nothing like medicine."
The man's interest in medicine resonated in his voice when he said this to the crowd.

"Keep the faith."
I got a second chance to shoot another question at Collins. This time I asked, "Looking back on your experience years later, if you had one piece of advice to give a medical student, what would it be?" I felt a drop of sweat plop against my skin after the question, as one of the ladies in the audience told someone next to them, "He must be a medical student." When I heard that, I'll admit that I kind of laughed under my breath. However, again, with a deep pause, Collins replied back to me that simple quote. He then said, "As medical students, you come in idealistic... as residents, you might come out cynical." True, medical school can do so much to the students that are in it (I think I see some cynics already :P).

---

At the end of all this, I can see some of you saying... Yeah, anyone can say any of that. True, but with these quotes coming from someone who broke through the obstacle of a non-scientific background to become a distinguished physician... to me, it means so much more. I'm now ready to hit my notepads and books once again.

I'm looking forward to reading Dr. Collins' Blue Collar Blue Scrubs... but for now, I gotta believe in the system.

Shortie: Family Values

Above: No other great family gathering than getting around greasy Chinese food.

Last sunday. I'm at one of the nearby Chinese buffets (which by the way are unbelievably unhealthy, but yet so irresistable). As my mom and dad are I having some healthy conversation on what's going on in my mom's workplace (which is always pretty entertaining), I look over and there's a pretty attractive girl sitting there with her family. There I am... staring... actually getting kinda distracted (okay, horrendously)... and then she pulled the ultimate turn off...

She yanks out her cell phone and starts texting in the middle of a family conversation.

And she keeps texting... and texting... and texting... Minutes pass by; minutes that I see precious enough to spend with family. Quite disgusting, if you ask me.

Folks, I'm not even close to married yet, and It feels weird to already have these warning lights flashing. It's just that the coherent concept of family is so important. I just can't stress the importance from family being the indestructible backbone of support to their kids to families keeping open channels of communication. And, how can I speak of this? It's because I experienced how critical family support has been in getting me to where I am right now.

In a world where communication devices (cell phones, e-mail... Twitter?) can bring people together and make the world a smaller place, I can see how they can easily take families apart. No: I'm not wishing every minute to be family-centric, as every teen should have the right to go hang out with friends and be young. Nobody's young forever, you know. However, in a society that's getting busier every minute and won't stop for anyone, I believe its definitely rewarding to give a few hours to have that quality bonding time with family.

Remember: your mom and dad's clocks are ticking too...