Pre-departure meeting at Bjørknes

July 31, 2012 § 1 Comment

Today Skjalg and I attended an information meeting at Bjørknes. The meeting included representatives from ANSA (Associated Norwegian Students Abroad), a priest from the Norwegian Seamens Church, and students from Semmelweis and Pécs. The meeting’s attendants were a mix of students headed to Semmelweis and Pécs and the veterinary school in Budapest, Szent Istvan. I was really surprised that there were no students that were headed to Szeged. There was a period of time where we had considered that our first choice school, but I’ve noticed that it isn’t as popular as the other two among Norwegian students. The reason that we decided against Szeged was because it is not an accredited medical school in California – and I’m not going to get a degree that isn’t recognized in my home state.

ANSA

ANSA was started in 1956 and has grown to include over 13,000 members in over 90 countries. This organization essentially “takes care” of Norwegian students studying abroad. After the 2011 Japan tsunami, they were responsible for flying home all members studying there. They offer insurance, student bank accounts, scholarships and loans, and deals on flights through Kilroy. They are also available to answer pretty much any question a student should have, including: issues with the school, student aid, personal problems, and illnesses. The ANSA representative even joked at one point that some of the Norwegian embassies have admitted that ANSA has a better overview of students in foreign countries than they do.

ANSA Hungary has charity project called “Students help students” where members travel to Transylvania to help build student homes for orphans cared for by the Saint Francis Foundation. The majority of orphans complete high school and are accepted to universities, but are dependent on a place to live. By giving them a place to live, they are given a chance to complete their university education, and thus become a beneficial resource for Romania’s future. The first student home was built in August 2009. There are now two homes housing 50+ students. The Saint Francis Foundation cares for some 2,000 children and there are increasingly more that need somewhere to live. The plan is to build a large student home –  800-1,600 sq. meters (8,600-17,200 sq. feet) – with room for 50-100 students to live and for facilities such as a library and common area. This is something that I am VERY interested in participating in.

ANSA Calendar 2012-2013

  • September
    • 3rd-8th: Introduction week in Pécs
    • 8th: Treasure hunt and start of Introduction week in Budapest
    • 10th-14th: Introduction week in Budapest
    • 15th: Sports day and concert in Budapest
    • 21st: First pub quiz in Budapest (of which there will be one every other week for as long as possible)
    • 28th: First pub quiz in Pécs
  • October
    • 4th-7th: Romania Charity Trip
    • 28th: Pub quiz in Pécs
  • November
    • 30th: Christmas porridge in Pécs
  • December
    • 2nd: Christmas porridge and service with ANSA priest Tim Georg in Budapest
  • February
    • 3rd-9th: Ski trip in Austria
    • ?: Medicine Seminar
  • March
    • 2nd: Charity Ball
    • 14th-16th: Kick-off/organization course
  • April
    • 27th: Volleyball tournament
  • May
    • 17th: Norwegian Independence Day celebration

Checklist before leaving for Hungary:

  • Passport
  • Order health insurance card at helfo.no
  • Order insurance
  • Apply for student loan and aid through Lånekassen
  • Change of address
  • Pay tuition
  • Have back-ups of bankcards – it takes a long time to send new cards to Hungary in case you lose yours

Priest from Norwegian Seamens Church

His number one tip was to enjoy yourself. He said that many make the mistake of locking themselves up in their rooms with their books and cut themselves off from other people. This is something that is natural when facing such a challenging study load. The only problem is that, when you hit a wall – which you will – you won’t have the support you need to overcome it. The ANSA-Priest acts as a sort of commissioner. He comes running when help is needed and is in a position to drop everything at the last minute. He stays neutral and is available to anyone in need of someone to talk to. He told of an instance two years ago in which a Norwegian student was murdered by her Chinese ex-boyfriend. Together with ANSA, he offered invaluable support and counsel for friends and family of the girl.

Advice from current students

For this portion, we were split into Semmelweis and Pécs groups, so I cannot account for the advice given to students heading to Pécs – though some of it may still apply. There were two guys, one studying medicine at Semmelweis and the other studying architecture – both are heading into their 5th year. Their advice included:

  • General

    • DO NOT procrastinate. Exam topics are available from the beginning of the semester. Print them out now so that you know what to study.
    • Be prepared for the fact that you are not going to feel like a medical student for the first two years. You will when you start clinical training in year 3, but before that it is all theory.
    • You can get all the books you need at the bookstores in Hungary – and they are usually much cheaper than in Norway.
    • The teaching style is much more formal, more old-school and strict than in Norway. In Norway it is almost impossible to fail. In fact, it is actually easier to succeed than to fail – and this is not the case in Hungary.
    • Keep in mind that you may come from a country that is financially better off. The money you get as a student may not be far off from the wage of some of your professors. Show respect.
  • Exams

    • Everyone will fail at least 1 exam – so be prepared for it. Failing one exam does not mean that you will never pass the class. You can fail the exam one week and then ace it the next.
    • The exams vary in their style. Some are verbal, where you pick a card and answer all questions regarding that topic. Some are multiple choice. Others, like physics, include essays.
  • Apartments

    • Avoid Tower Rentals agency like the plague. Some have had luck with them, but the majority of students have either neutral or horrible experiences with this agency.
    • Make sure you see the apartment for yourself first. Take time to experience the area.
    • Public transportation is amazing in Budapest, so you don’t have to look for places right next to the school. A student card costs only 100,- (about $17) a month for unlimited use.
  • Taxis

    • ALWAYS, ALWAYS, ALWAYS pre-order a taxi over picking one on the street. This is the number one way to get tricked out of your money. There are many unregistered taxis that will charge 3 times as much. I head read numerous horror stories on various blogs.

To close out this post, I want to share a funny story told by one of the students in regards to one of his verbal exams. It was an anatomy exam and he chose a card concerning the back of the calf. The teacher point to a nerve and asked the student to name this nerve. The student mistakenly thought it was a tendon and proceeded to identify it as such, to which the professor replied:

“Jan Erik, Jan Erik. I think I know streets of Oslo better than you know anatomy. Please leave and return when you have studied.”

Here we go!

July 26, 2012 § 1 Comment

Our second round of books came today! They’ve been piled on chairs in the living room and I figured it would make for an interesting photo. I can’t believe that all that information is going to be in our heads! The pile on the left includes Skjalg’s and my books and those on the right are Christian’s. The booklist for Semmelweis won’t be released until August 20th, so we have only ordered ones that we know we will need so far. Christian has double of several of the books because he had to order a second round that would be guaranteed to be delivered before he left and was unable to cancel the first order.



Det er ikke bare bare å begynne på medisinstudiet….

July 25, 2012 § Leave a comment

The first half of the above phrase is a saying in Norwegian. I remember hearing it when I was first learning the language and having no clue what it meant, even after it was explained to me. As my understanding of the language and culture grew, I was finally able to incorporate several Norwegian sayings into daily conversations. Each successful delivery was followed by an imaginary one of these:

But the “det er ikke bare bare” phrase eluded me. I have yet to find an equivalent of this phrase in the English language. Directly translated it means “it isn’t only only” – which obviously makes no sense. The best English translation is “it is not necessarily very easy”. I don’t find that this translation does the phrase any justice. It doesn’t capture the quirky irony of the situation the phrase refers to. And in this specific case, I am referring to the starting medical school.

Just starting medical school is a feat in itself. You are constantly thinking about the impending study load and mental challenges. You are making a huge commitment and it requires that you trust yourself, that you are positive that this is what you want to do. On top of that, we are moving to a country with a culture different from any I have experienced before. I can prepare myself all I want by reading forums and blogs online, but nothing is going to completely prepare me. I honestly feel like the simple act of starting school this fall, including the move, is sufficiently worrisome. But hasn’t been, and isn’t going to be, so easy. I don’t know if I will feel secure about any of this until we are into our second week, if not month, of school.

Skjalg has a blog of his own. He hasn’t written too many posts yet, but will be writing more as the year starts. He did, however, write about post about the main struggle to which I am referring to (this can be read here). I’ve written about this same issue before, in my This too shall pass post. Essentially, Skjalg doesn’t know which school he is going to yet. In March, he was accepted at all three medical schools. The three schools have slightly different standards when it comes to satisfying the general education requirement – and Semmelweis is the toughest one in this case. Skjalg completed a year of an accelerated engineering program instead of attending the normal 3 years of high school. He satisfies the general education requirement in Norway through the 23+5 rule (which means that he is older than 23 and has 5 years of practical experience: either work, school, or military). Pécs accepts this rule, but Semmelweis is unclear about whether they do or not. July is vacation month in Norway, so trying to get ahold of people is challenging to say the least. (I should also point out that Norwegians are required to take 5 weeks of vacation a year, so in July they usually take the entire month off).  On Monday Skjalg was finally able to get ahold of our contact person at the school hosting our applications. She told Skjalg that he has to get a 100% answer from the school, and then told of a story in which several students in Slovakia were kicked out during their 5th year of medical school when it was found that they hadn’t met the general education requirements when they applied. She followed up with some good news, that Skjalg had been re-accepted to Pécs.

So, Skjalg is leaving next Tuesday for Budapest. The trip’s original purpose was to find an apartment, but now he must also get a firm confirmation from Semmelweis. In order to plead his case, he is going to bring some extra supplementation: confirmation from the accelerated program he completed that he “has achieved general university admissions certification” as well as proof that he can be accepted to a university in Norway and proof of his 5 years of practical experience. If they say OK, then everything will continue as planned and we will both be going to Semmelweis. If they say no, well, then, he is going to Pécs and I will have to make a big decision of my own.

I don’t mind challenges, and it could even be said that I like them…but I have to say that it is a lot nicer looking back at them than being right smack dab in the middle of them. He won’t have an answer until next Wednesday and until then, we just have to keep preparing as we have been.

Death and Commencement Speeches

July 22, 2012 § 1 Comment

My Aunt Aida, when she was visiting us in Oslo, recommended a movie to Skjalg and I called “Gross Anatomy”. I had never heard of it before (I even thought for a moment that she meant Grey’s Anatomy…). She thought we would appreciate the story – and she was right. It took a while to find a copy of it, but we were lucky enough to find it split into 8 parts on youtube.

One of my favorite parts of the movie was the commencement speech. I found it exiting and intimidating at the same time:

Welcome to medical school. Many of you have only been here a day or so, I’m glad to see that you could find your way here. My name is Dr. Rachel Woodruff and in the next 8 months you will be required to memorize 6,000 anatomical structures, read 25,000 pages of text, attend 200 lectures and pass, or fail, 40 examinations. If you fail a class, you have to repeat it. If you fail two, you have to repeat the entire term. If you fail three, well, let’s just say that you probably don’t belong here. Along with my duties as Associate Dean of Students, I also teach gross human anatomy. The one thing you’ve dreaded since the moment you made the decision to come here. (She wheels a gurney carrying a cadaver covered with a white sheet to the front of the stage). Nonetheless, it is the centerpiece of your first year of medical school. Systematic dissection of a human cadaver. (She slides the white sheet off of the cadaver, revealing it to the crowd. The crowd reacts.) This woman here, died in our university hospital just a few nights ago. It’s a very difficult thing, to face death. But that’s what doctors have to do their entire careers. In your first year of medical school, is a daily, hands-on exploration of it. It’s not easy. It’s, uh, certainly not pleasant. And there is just absolutely no reason for you to do it unless you want more than anything to be a physician. So if you’re not completely sure of that, I urge you to get up and walk out of this room right now. (Pause as students look around the room at each other). Good. I can assume you are committed, and I will help you – those of you that should be doctors – in any way I can. Oh, by the way, the profession you’ve just dedicated yourselves to carries the highest rates of alcoholism, drug-addiction, divorce and suicide. (And then she simply just walks away).

It got me to thinking… I have never actually seen a dead body. I’ve never even known anyone that had died. This is definitely going to be a big experience for me! I remember my mom telling me that seeing a cadaver for the first time was one of the oddest experiences she’s ever had. And here I am, going from no experience with death to daily experiences with it. I think we even begin dissecting upper limbs in week two of anatomy class…

Curriculum for the First Year

July 21, 2012 § Leave a comment

The following curriculum covers the 2011/2012 school year. Semmelweis has not yet released the curriculum for this year, but I can’t imagine that they are going to make too many changes. We’ve been informed that new information will be available online from the 20th of August.

Each semester includes three modules. The first module contains the main courses, the second the obligatory electives, and the third the optional electives. I can’t wait to get information about how the electives work. The main course load is already 26 credits and with the obligatory electives it is up to 32. This can’t leave too much time for the optional electives…and I kind of want to do them all. If the credits are calculated the same way they are in the States (1 hour of class = 1 credit), then I imagine I will be overloading it a little by taking 47 credits…

First Semester

Spring Semester


First round of books delivered!

July 21, 2012 § Leave a comment

I’ve been anxiously awaiting the arrival of our books. Nothing makes me feel more like a student than textbooks. The ones that arrived today were those that we ordered through amazon.co.uk. I recently posted blog where I detailed how we went about ordering our books.

This shipment included 1 anatomy atlas, 2 anatomy textbooks, and 2 histology textbooks. We were really excited to look through them. It was crazy to think that these books will be recurring characters in our daily lives for the next 6 or 20 years.

Skjalg checking out the anatomy atlas

He wasn’t quite prepared for some of the images…

Mmmmm! Face cross-section 🙂

What made you want to become a doctor?

July 21, 2012 § 2 Comments

I’d like to think that anyone heading to medical school – whether thinking about it, applying, or already starting their studies – is often asked THE question. It comes in several variations but most are along the lines of: “what made you want to become…” or “why do you want to be…” or “how did you know that you wanted to be…” a doctor.

Ever since I was little girl, I’ve had pretty grandiose ideas about what my future career would be. I once came across a 1st or 2nd grade class assignment, from when I was about 6/7 years old, where I had illustrated and written – in my barely legible, learning-to-write handwriting – that I wanted to be an astronaut. After that my mom started law school and I wanted to be a lawyer – just like my mama! Not long after – and I don’t know exactly when – this changed to doctor. People I met in my daily life would ask me the quintessential question for children: what do you want to be when you grew up? To which I would answer, “A doctor. The kind that does everything.” If my mom was there she would fill in the title that I never managed to say, as it was too rich for my pre-adolescent vocabulary: general practitioner.

Once I decided that I was going to be a doctor, I knew that I had to test myself as much as possible – just to make sure that this was what I really wanted. I began studying everything that happened during my doctor visits, which wasn’t very exciting in the beginning. The most I did was stare intently at the entrance of the needle into the veins of my antecubital fossa (the crook of your elbow…. or elbow pit as I like to call it). I knew then that there would be much worse things to “handle” in the future if I was to become a doctor.

My biggest can-you-handle-being-a-doctor test came when I was a freshman in high school and it requires a bit of a back story. I have hyper mobility syndrome, which, put simply, means that my joints stretch farther than normal. The best instance of this is my left knee, which I dislocated for the first time while playing kickball in 3rd grade. I was taken to the hospital in an ambulance and had to use crutches for a couple of weeks (which is maybe where I got my first taste for medicine?). After this initial dislocation, my knee cap became no stranger to slipping out of its joint. If I got up the wrong way, skipped, hop or ran the wrong way, it would dislocate and I would sit in whichever spot I fell until I regained the strength to get up and walk again. These numerous dislocations took their toll over the years and when I was 15 it dislocated for a last time while I was log wrestling with my best friend Amy. There may be a more technical term for it than “log wrestling” but it is essentially where you and an opponent stand on top of two huge, parallel logs and see who can stay on their log the longest. Well, I slipped off my log and my left leg got jammed between two smaller logs, dislocating my knee. My orthopedic surgeon later explained that, with this dislocation, I had torn a weakened muscle off of my knee cap and needed surgery to repair it.

For those interested in reading about my surgery, I will include a more detailed description at the end of this post. Here I will share what my orthopedic surgeon told me, and what I subsequently repeated to every doctor I’ve seen since then. He explained the following:

You have shallow joints and have dislocated your left knee so many times, and over such a long period of time, that there is a good amount of damage in the area surrounding the knee-joint. You have a muscle that runs down from your hip to your knee. You have torn this muscle and I need to remove the section of it that is too stretched out to offer your joint any support. I will cut off about 4 inches and then reattach it. I will also need to perform arthroscopic surgery on either side of your knee. I will make a two small incisions and go in with a small camera. You have two tendons that run down the sides of your legs and stabilize your patella (knee cap). The one on the outside of your knee has become too tight and is actually pulling your patella out of the knee-joint. I need to trim this one so that it loosens up. The one on the inside of your knee is too weak and isn’t really doing what it is supposed to. This one needs to be cut and retied so that it is tighter.

Now, as I wrote earlier, I was about 15 when he explained this to me so the details may not be 100% accurate. I’ve looked up my surgery and at diagrams of the knee several times since and find that I can’t quite connect my understanding of the surgery with what I’ve found online. However, I have repeated the details of my surgery to about five doctors since and have yet to be corrected (though that could be because they don’t want to waste time explaining it to me). The most feedback I’ve received after explaining my surgery is that the surgery is no longer performed due to its high failure rate. I expect that I will understand my knee surgery much differently after medical school.

Here’s where it gets interesting. Watching myself get basic shots and vaccines wasn’t cutting it in terms of challenging my ability to handle being a doctor. I needed something bigger… something more disgusting! So I asked my orthopedic surgeon if I could watch my knee surgery. It was definitely unlike any request he’d had before, but he agreed. One thing you have to remember is that this was back when managing to upload a single, grainy picture onto your computer was an amazing feat. This was three years before YouTube and Facebook were created. A quick internet search today will bring up any surgery video, including the exact surgery I had, within seconds.

On the day of my surgery, I was only partially anesthetized so that I would be able to follow along with the procedure. I was only able to watch the arthroscopic surgery on a TV screen above me, as it is quite hard to study your knee while laying on your back and temporarily paralyzed. But it was amazing. Simply…amazing. The human body seems so sacred at times. We are beings of life, of emotion and passion. There is a mental connection and response to every part of our body. We are aware. And to see the inside of my body, to see someone scraping and prodding and poking, and have no mental connection or response to it was unlike anything I have every experienced. Something changed in me then, something that I wouldn’t really appreciate, much less fully understand, until now. It’s the ability to look at the body as a biological machine, as a combination of it’s billion, if not trillion, functioning parts. To look at HOW we work. To assimilate our bodies with cars and moving toys. To look at the human body just as it is, outside of the presence of the soul. I’m getting excited just writing about it now. It’s fascinating. Truly and utterly fascinating.

One thing I’ve learned about myself as I’ve grown older, mostly through people pointing it out, is that I have a pretty extreme sense of empathy for not only living creatures but even material things – and this isn’t always a good thing.  When I picked flowers as a little girl, I would tear out a single hair from my head and lay it where the flower had been, as some sort of exchange. When Skjalg and I go for walks in the woods, I will move snails out of the way. Once, on a walk in the rain, we came across a writhing worm in the dirt path. He told me that it was probably being tortured by the intense vibrations of the rain drops. I felt so bad for the worm that I picked it up and placed it in a mushy mud section on the side so that it could escape more easily. Expressing sorrow or sadness about anything in my own life isn’t nearly as easy for me as for expressing it for something is someone else’s, whether in real life or movies (even cartoons!). Christian walked in on me crying once while I was watching Disney’s Tarzan – one of the parts in the beginning where Phil Collins is singing… maybe I never matured past 8-years old?

This is how I know I am going to be a doctor – my passion for the body, my ability to handle “grossness” and my empathy for people, not just for their conscious self, but for their biological beings. While studying the immune response for the entrance exam, I could not stop raving about the individual cells involved. I got so excited reading about them, learning what they do and the role they play in the human body. “Skjalg! Skjalg! Did you know that cells that are damaged or infected will actually present this information on receptors on their surface??? They are informing macrophages (the cells that digest damaged cells) that they are infected and need to die! They’re essentially committing suicide by informing the body that they are potentially harmful!” I have a genuine physical response to the excitement I feel when I learn about how the body works.

Why do I want to be a doctor? Yes, I want to help people and yes, I love science. But honestly, the main reason for me is that I want to know everything I can about how the body works, I want to understand it, appreciate it and figure it out. I’m passionate about the human body and I feel empathy for its individual parts, even down to its little mast, t- and b-cells.

Check out Khanacademy.com’s fun video on Cytotoxic T Cells

Go cytotoxic t cells!

About my surgery

I’ve always thought that the main surgery I had was called patellic realignment. Google informed me that I am mistaken and the surgery is in fact called patella (or patellar) realignment.

Here are before and after X-rays of the knee:

Before surgery: misaligned patella

After surgery: realigned patella

After looking more at the anatomy of the knee, I suspect that it wasn’t a muscle that I tore, but possibly the quadriceps tendon – meaning that I misunderstood what the surgeon had explained to me. This tendon attaches the quadricep muscles to the knee.

The Shelbourne Knee Center says that there are two types of patella realignment surgery: proximal repair and trillat procedure. My arthroscopic procedure seemed most similar to the proximal repair. This procedure requires that the surgeon make a small incision on each side of the knee cap. The patella is stabilized by soft tissue (the retinaculum) and after a dislocation, the tissue on the inner side of the knee is torn or stretched and the tissue on the outer side is shortened. The proximal repair procedure tightens the stretched retinaculum on the inner side and loosens the shortened retinaculum on the outer side.

I have yet to find a source that explains the surgery that involved reattachment of a muscle (or tendon) but will definitely post about it when I do.

———————–

Source: http://www.fixknee.com/Trillat/patella%20tendon%20realignment.htm

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