Pathology, oh, pathology…

May 11, 2015 § 4 Comments

One week out from my first final and I can feel it in my entire body. For the past three days, I’ve done nothing but sit in my little study spot and push myself through topics. After so much work, I find myself already completely exhausted. And tonight, is the pathology competition.

I should be doing everything I am to cram for it, and trust me I will, but only with the time I have today. Last week, I had a goal of finishing 90 topics (we have 191 total), which I then had to adjust down to around 60, and I even fell short of that goal. Yesterday, I had to make a decision: give it everything I have for the competition, with what time I had left, or aim at finishing my topics. With the stakes for the competition being so high, I decided to go for the latter.

The competition will consist of 8 cases with 10-15 questions each. One teacher told their group that there will be 6 more normal cases and 2 really strange ones. Only the top three will get a prize: the first gets exempt from the entire exam and the second and third get exempt from either the theoretical or the practical portion. There is also a rumor going around that anyone that makes it into the top 10 will have a “nicer exam” based on their performance.

I really, really wanted to go for the competition, but I didn’t want to put everything I had into it and then fall short, leaving me with only 6 days to prepare for my final exam. In the beginning of the semester, the head of the department mentioned a book of cases available only in Hungarian that they soon would be translating into English. A couple of weeks ago, I heard that the cases for the competition would be taken from this book. I bought it (in Hungarian) and sat down with a plan to go through 20 a day for 20 or so days. The first two: took me 5 hours! I remember that night well because Skjalg and I got into a big discussion about my beliefs about what is possible or not. Even though I knew it was impossible to go through 290 cases in Hungarian in just under 3 weeks, I couldn’t stop myself from feeling like I’d failed.

We ended up finding someone who was willing to translate the cases, but that plan fell through. So, the cases have just been waiting there, taunting me.

Screen Shot 2015-05-11 at 07.45.24 Screen Shot 2015-05-11 at 07.45.33

I’m feeling so scattered at the moment, so I really don’t know if this post is making any sense. The reason I started writing (rather than sitting down to start cramming) is because I felt the need to mentally prepare myself for today. I am so used to giving 100% of myself to my tasks that I have a really hard time when I can’t. The hardest of all is when I’ve made an active plan not to. My natural instinct is to feel like I’ve failed, so I need to work against that and look at the good. I made the decision to prioritize topics over the competition. Studying for it today will be a benefit to me – no matter the outcome – because I will have to apply my knowledge in a different way than I have been doing. It will allow me evaluate the practical use of my knowledge and give me an idea of where my focuses need to lie in these next days before the exam.

It’s hard to put so much work into an exam and not be assured that it is going to go well. For the past few weeks, I’ve done nothing but study patho. The idea that that still may not be enough makes my stomach turn. Still, this is a mountain and the only way I’ll climb it is my taking it one step at a time.

This is what my weekend (or life) looked like this past weekend. I really enjoyed the clouds – as you can tell!

20150509_18514520150509_202756

20150511_070205

So strange that this much time, work and energy can still feel so inadequate…

Whenever new students ask me for tips, the first thing I say is, “Evolve, constantly.” This is actually something that I have struggled with myself quite a bit. I never really know when enough is enough and rather than thinking “they seriously can’t expect us to know all this”, I think “why can’t I get all of this in my head?”. My friend Amir said something really good that I’ve been repeating to myself, “I’m a medical student, not a parrot”. I like that way of thinking and believe it to be true, I just need to figure out how to gain confidence from it.

The reason I brought up the “evolve” idea is that my notes for this exam are a perfect example. I’ve gone from doing 1 topic a day to having to cram in maybe 10 or more. I’ve had to sacrifice doing the topics the way I would if I had all the time in the world for progress. In the end, I’ll never have all the time in the world, so might as well learn that lesson now.

In the beginning, I typed up lecture notes and topics in my iPad.

2015-05-11 07.11.03

20150511_070717

Then I started writing them all out by hand, making sure to make plenty of charts or diagrams to make the information more fluid (at least for me):

2015-05-11 07.10.22

Then I thought I should go back to doing it on my iPad – but this time print out the notes. This ended up being too time consuming and honestly, I can’t afford to pay for that many color copies!

20150511_070507 20150511_070535

Finally, I found something that worked. There are two sets of “notes” made my previous students. One is by a girl who recorded the lectures and has created topics based on those, while filling in from the book. She’s squeezed most of them onto 2-4 pages, so sometimes I have a hard time following the structure. The second is by a guy who made summaries based directly on the book, with some input from lecture. What I do now is read the topic in Robbins, while following the summary and adding in my own notes, then check the organization of the topic in BRS and then create my own little summary page of the topic. Finally, I look at the first set of notes to see if I’ve missed anything. While I’m preparing the notes for a topic, I’ve also started a habit of googling the disease and leaving up the image search on my screen, so that I look at it while I’ve coming the topic.

For this one, I was still writing out too much info

For this one, I was still writing out too much info

20150511_070249

My summary page…

20150511_070307

…and an example of the typed summary with my notes added

20150511_07033720150511_0704292015-05-11 07.09.47

Ok, getting too anxious now! Off to cram, go to lecture, go to class, cram, then finally challenge my knowledge. It’ll be great no matter what happens 😉

 

“You should be a surgeon”.

May 1, 2015 § 4 Comments

It’s an absolutely beautiful day in Budapest. May is here and that means one thing: exam period is coming! Registration on Tuesday went really well. I used my little tricks and had registered for all of my exams within 40 seconds or so. When it was over, panic began to settle in. All of a sudden finals are real! For the first time I’m taking a big exam on the first date. Last year I took the physiology final on the first Wednesday, but it doesn’t feel the same since we had to study physiology so consistently during the semester (we had two quizzes every week, one on lecture material from the previous week and one on the lab material for that day). My exam dates are as follows:

Screen Shot 2015-05-01 at 10.04.59

With the pathology final so early, I have to go super exam-mode from now. I’ve known for a while that patho would be my first exam (it was just a matter of getting a spot during registration), so I’ve been studying patho for the past few weeks already. My plan is to get all my topics together and then spend the last week just reviewing and memorizing. I am already feeling so nervous about it….I really hope the anxiety doesn’t get too great.

Yesterday we had our second laparoscopy practice in surgery. There are two competitions in our Basic Surgical Techniques class: (1) suturing and (2) laparoscopy. During the laparoscopy practices, we were timed while completing various tasks and the person with the best time was selected to go to the competition. For the first practice, we were tasked with using one hand to organize different colored rolls of paper into bowls and then to place the cap on a needle. For the second practice, we had to move colored rings from pegs on one side of a board to the other, passing them between the tools on the way, and then back again. At the exam, this needs to be done in under 2:30. During the first practice, I had pretty decent times: 0:31 for placing the paper rolls in bowls and 0:05 for placing the cap on the needle. The peg board with the rings was by far the most difficult task. We trained for about 40 minutes and were then timed by either the teacher or visiting teaching assistant (TA).

20150430_152033 20150430_151836 20150430_151826

I was feeling pretty nervous, even though I am already exempt from the exam after the suturing competition. Even though I was shaking a little bit, I started singing a song in my head to keep me calm and then just systematically went through the motions. All those hours spent playing Skyrim and Assassin’s Creed in the past must’ve paid off because I managed it in 1:09. I didn’t really realize what this meant until people around the room started reacting in disbelief. I later learned that the record last year was 1:23 and that someone had beaten it the day before with a time of 1:21.

After some exclamations were made, my teacher said something that probably meant nothing to her, but everything to me, “You should really be surgeon.”. Lately I’ve been pondering the concept of talent quite a bit. There is this notion that there are certain careers or lifestyles that people are meant for and sometimes I worry that, because I am such a hard worker, that I will never know what I am truly, inherently good at. I’ve been worried that maybe I don’t have a talent for medicine/medical school and that later down the line I’ll learn that the only reason things went this way was because I kept pushing for it. In the end, I guess it doesn’t really matter. I have such a passion for medicine, I love studying it and I look forward to a career in it. At the same time, I feel sad thinking that there is something I have a true talent for that I will never discover because I am always pushing in other directions.

I’ve put so much pressure on myself in this surgery class this semester because I know that I want to be a surgeon but have been worried that I don’t have a talent for it. Whenever people have asked me what kind of doctor I want to be, I’ve always told them a surgeon and then added that I have to “see if I’m good at it first.”. My little successes in this class have made me start to believe that it is possible that my passion and talent might one day be the same. My teacher saying this seemingly simple sentence to me meant so, so much to hear. Hopefully it’s the beginning of a long and exciting journey.

I won’t be partaking the laparoscopy competition (due to my previous exemption), but it feels good knowing that I could have. In the grand scheme of things, this is nothing big, but it has fueled a little fire burning inside of me and for that I am grateful.

Now it’s time to go exam period mode for the weekend. I’ve started out the day with an intense workout and filling breakfast and am ready to dig into patho. I have quite a few emails from blog readers to reply to that I will be responding to during my breaks (just in case any of you are reading this – I haven’t forgotten!). I’m looking forward to spending the next 72 hours in my little study area 🙂 Since today is Labor Day in Hungary, my studying will be accompanied by the sounds of the air show taking place down by the river. At least I won’t be alone!

20150501_095743

Life Points

April 28, 2015 § 3 Comments

That medical school is a stressful experience was no surprise to any of us. What did surprise me, however, was how much of that stress revolves around how I handle and view stress. It’s been quite the battle over these past two and a half years and I’ve made progress, but I’m nowhere near where I’d like to be. During this chapter of our lives, we’re meant to be broken down while simultaneously pushing forward. Any upset of that balance throws us into a series of challenges meant to restore it.

Previously, my thought process has been that my best chance is possible only if I devote every free moment of my time to studying. The problem with this is that you are never satisfied. Why? Because you will never, ever, be done studying. So, this semester, I have been trying to balance out my life a little bit.

To be completely honest, I wrote those previous paragraphs on April 3rd. I remember that night because I was feeling calm, happy and balanced. I felt it so strongly in that moment that I thought there would be no way I would forget that feeling. And that meant that I could put the computer down and enjoy a movie night with Skjalg.

Now it’s been almost a month. A lot has happened in that time. Many great memories have been made. But tonight, is exam registration. The single most stressful event of the year (depending on who you ask). At 21:00, all of us will log into our accounts on Neptun and furiously battle it out for the few spots available for our desired exams. I’m getting stressed now just writing about it. I was hoping I could escape the stress of the upcoming exam period and complete this post, but I’ve lost the path to that mindset. At least for now.

FB_IMG_1429941633826

Since I should be studying (when is that not true?), this post is going to be a series of shots I’ve snapped over the past few weeks.

March 25th – Since Jannie moved, we don’t study together in person as much anymore (she used to live only a minute away) – so we do it on skype! Gotta love modern technology 😀

IMG-20150325-WA0006

March 29th – Our friends from Norway, Roar and Karolina, came to visit for a few days during Easter Break with their adorable son Håkon. On their first day, we grabbed a bottle of wine from Di Vino and walked up to the Parliament building to enjoy it with the sunset.

20150329_183248 20150329_183233

March 30th – Fun Easter decorations in the Easter market

IMG_0312

April 7th – We had two microbiology midterms this semester and both were scheduled for Week 12 – quite late! Luckily, some of the teachers were flexible and allowed us to take them early. I took my first one (mycology and parasitology) before Easter Break and towards the end of the break, made the decision to do the 2nd (virology) on the first day back. That meant 3 days of exam period style cramming! Thank goodness for SketchyMicro!!

20150407_001058

April 9th – Spring hit Budapest – and people were enjoying it everywhere!

20150409_185251

April 10th – Sunny study spot! Cramming for the Genetics midterm had begun.

20150410_145048

April 12th – Making Skjalg pretty 😛 His hair has gotten so long!

20150412_113221

April 15th – Hugo came to visit Budapest! Unfortunately, we completely forgot to take a photo when we met for dinner. So, I had to steal the one he sent me from when he celebrated his birthday.

IMG-20150416-WA0003

April 16th – Such a beautiful day – so psychology class took place outside in the park! I wasn’t feeling well that day, so I missed out, but Skjalg took this photo so I could see how nice it was. We were really lucky with our psychology professor this semester. He is extremely engaged and really wants us to understand and enjoy psychology.

IMG_0361

April 19th – Skjalg ran the Budapest half-marathon. He did an amazing job: 1:59 for 20km!

April 2oth – Beautiful morning on the way home from the gym. Took a moment to relax in the sun and enjoy the moment with coffee and coconut water.

20150420_082142

April 21st – Skjalg and I were feeling a bit down so I made these amazing protein powder cookies I discovered on instagram. The author’s (jazzythings) were a lot prettier than mine, but they still tasted great!

April 24th – There are some American medical students visiting from Buffalo. They have been here for a month, but we didn’t meet them until last week. We invited them out for drinks at Akvarium and ended up being a huge group. It was an amazing night – much nicer than sitting inside being exhausted and pretending to study!

IMG_20150424_023235

April 25th – Hanna came over for a girls night in. We made our friend Stian’s “Healthy Snickers Cake” and watched Dirty Dancing 2: Havana Nights. She just got back from Cuba a couple of weeks ago and I thought it would be fun to “go back” for the night. While making the cake, we got a call from Stian and his boyfriend Kim back in Norway 😀

IMG_20150426_221952

April 27th – Beautiful sunset! Wish I had caught it in time. Might be nice to leave the apartment sometime ;). Quest bar “apple pie” with greek yogurt (mixed with PB2) for dinner.

20150427_194216 20150427_215519

 

That’s all for now! Tomorrow is our last midterm in a class called Medical Imaging, which is split into an anatomy part and a biophysics part. Tomorrow’s midterm is the biophysics part and let’s just say I need a miracle for that! Haven’t touched biophysics since first year!

Screen Shot 2015-04-28 at 12.33.40

 

 

Time is the longest distance between two places

February 28, 2015 § 6 Comments

Time has, yet again, completely eluded me. We have just finished week 4 of our sixth – our sixth! – semester. It feels like we’ve just started. At least until I look back and focus on some of the things we’ve done and learned. In those moments, I realize how far we’ve come.

Third year has been by far the busiest (something that is clearly reflected in my activity on here). I’ve planned my schedule in such a way that there is something I should be doing during almost every hour of the day. The breaks between my classes are sometimes barely enough time to run to the restroom and once I’m done at school I have to get as much studying done as possible.

We have very few midterms this semester, so pretty much everything is riding on our levels of self-motivation. Lucky for me, that’s one area where I’m not lacking. Though this self-motivation is chiefly anxiety driven, I’m just happy that I am getting somewhere.

I’ve still be struggling a bit with exactly how I should study for all my classes. In their respective classes, all the subjects seem so important. Prioritizing one of the other has been pretty difficult for me. So, I had to just decide to put most of my efforts into pathology. It was my worst subject this past exam period, and I think it deserves more attention this round. Plus, our final exam in it is going to be a monster. It will consist of several practical parts and then one theoretical part, consisting of 3 hand selected topics from a total of 191 topics (check the list here)! For the practical part we will have:

1 specimen identification with description (there are around 70 or so pathology specimens (body parts) in sealed jars)

All 3 pathpots

1 histopathology identification with description (i.e. told that this is the small intestine, identify that it exhibits features of Crohn’s disease and discuss the theory behind it)

Crohn's Disease

1 autopsy case: we will be presented with the internal organs of a patient, given time to examine all the pathological changes, and then determine the cause of death (primary disease) and any secondary complications.

1 case report: we will be asked to discuss one of the autopsy cases we reviewed during the semester (we have a total of 14, of which 10 will need to be remembered for the exam).

At the moment, my study technique is to prepare the topics as I would want to present them on my exam. For patho, I’ve switched to taking my notes in a notebook. I’ve found that the freedom of the note-taking app on the iPad is great for some classes, but more “damaging” to others (efficiency and efficacy-wise) . For example, for the pathology topics I did in my iPad, I unconsciously spent way too much time making the perfect layout and having all the points in a perfect order. Now, I read though the book, then through my lecture notes and notes written by a past student. After that, I visualize a sort of “topic- map” for myself and only then do I draw it out into my notebook. When I add in things, it can get a little messy, but I can tell that I am actually learning a lot more than when I took notes in my iPad.

Before: on iPad

IMG_0852

After: notebook

IMG_0856

But then for microbiology, it is really great to have the iPad notes. We have to learn so many different organisms and one of the ways to do this is image association. Last semester we covered bacteria and I used SketchyMicro. They just announced that they will be releasing videos for viruses and fungi on March 14th this year and I couldn’t be more excited! Before they announced the release though, I figured I had to take things into my own hands and make my own drawings. I did several for protozoa and Notability was the perfect tool!

Example of SketchyMicro’s images

Staph Aureus

Bianca style! 😉

IMG_0850IMG_0859

Outside of these, we still have pathophysiology, genetics, surgery, internal medicine, medical psychology and…I honestly can’t remember the last one. Oh! Medical imaging.

Last week, we were supposed to have our first surgery practice, but we missed it. There was a lot of confusion around it because we were supposed to take it during the second week but there was a conference, so they moved it to the third week. We thought that the retake would be on Thursday, the normal day of our practice, but when we got there we found out that it had actually been the day before! We were both really bummed, so we decided that to make up for it, we would do a “surgery date night” that Friday.

Skjalg picked up surgical tools at school and we settled in for the night with some partially peeled oranges. We didn’t have any proper training, but it was still fun to pretend.

My first ever sutures!

My first ever sutures! Now I know that they are a) cut too close to the knot, b) knots shouldn’t be over the wound site, should be off to the side c) too close to the wound edge, d) not properly spaced 😛

This past Thursday was our “second” surgery practical and was going to be our day of learning sutures! Since Skjalg and I had practiced at home, it wasn’t too foreign. Although, there were a lot of “rules” that we hadn’t followed properly and suturing an orange is a lot different than suturing the weird tissue sponge thing we had in class. We spent the first half of the class learning two knot types: Viennese and surgical. We need to know how to do them with both hands and let’s just say that I was completely unaware of just how lacking my left hand is when it comes to dexterity. Practice, practice, practice!

For the second half of class, we practiced suturing. After about half an hour, our teacher told us that we had 10 more minutes of practice and then we would have a little competition. I suddenly got nervous and started shaking (great) and when she came over to check my work, I proceeded to do every single thing wrong (i.e. breaking the needle in the “tissue”, holding the forceps wrong, pulling the thread all the way through the tissue, making a knot in the thread before I was done, etc.)! Luckily, it was still practice time…

When the 10 minutes were up, she told us to clear our sutures and prepare for the competition: 3 stitches in 10 minutes. Since I want to be a surgeon and this is the closest thing I’ve ever been to that, I was putting a lot more pressure on myself than logically necessary. Still, I managed the three sutures and then did a forth just in case. The sutures have to be 1 cm from the wound edge, 1-1.5 cm apart from each other (and parallel to each other), and the thread should be cut 1 cm from the knot. After 6 years, I’m still in this weird limbo state between inches and cm, so I was a little worried I’d over(or under)estimated.

After the time was up, we all got up and walked around to examine each other’s sutures. We each then chose two people to vote for. Once the teacher had tallied the votes and announced the winners, I was shocked to hear my name called for first place. There are two more little class competitions and then the winner gets to go to a competition for the whole year. At this competition there will be one person from each group. The top 3 will get a grade of 5 for the class and the rest will get 4’s – so it is a pretty good deal!

FullSizeRender

Ok, back to patho for me!

Post title: Quote by Tennessee Williams, The Glass Menagerie

6th Semester’s a go!

February 4, 2015 § 4 Comments

School has started and I should be in bed. It’s early…or it’s late…depending on who you ask and what their personal day rhythm is like. Considering I have to get up at 6:00 and should be aiming for 8 hours of sleep, I’m going to go with “it’s late”.

After exams were over, my body somehow adapted an entirely new sleep schedule. I think it was the excitement of being able to stay up and do nothing coupled with the pleasure of sleeping in because there was nothing to do. So, slowly over a week, the schedule changed from around 23:00/midnight to 7:00/8:00 to 03:00 to 10:30 (and sometimes, embarrassingly enough, 11:00). It was horrible and wonderful at the same time. I really loathe waking up late. It makes me feel as though I have wasted the day away. Is there anything charming about having breakfast at 14:00 in the afternoon? However, after the brutal hell of exam period, it became a guilty pleasure. Why am I bringing this up? Well, because I never worked back to a normal schedule and now I am paying the price. I’m too awake at night and dead tired during the day. Self-imposed pseudo-jet lag we can call it…

Today was a long day of lectures and a 2 hr 15 min internal medicine practical. The schedule has changed this semester so we are in a totally different group, on a different floor, with a different teacher. While I am a little sad that it won’t be the same as last semester, I am looking forward to new challenges. The doctor we are assigned to is gone this week, so we had a substitute teacher. Hopefully we’ll be happy with the one we end up with (his name means champagne in Hungarian, so he can’t be all that bad). Dr. Champagne

My groupmate Batel and I were assigned a patient together and after the session was done, we stayed after to ask our substitute teacher questions about our patient’s diagnosis. The patient was quite old, very weak and had a violent cough. We were able to find that his/her heart was enlarged, but nothing past that. (Every time I have to present a patient…).

The doctor shared that the patient suffered from dilated cardiomyopathy and had acquired bronchopneumonia while in the hospital. The cause of the heart condition was chronic alcohol abuse, which we wouldn’t have been able to diagnose during our examination because the patient had told us that he/she had never consumed alcohol. (How I feel when the patient tells me one thing and then tells the attending something completely different).

Despite the long day, I’d planned quite the study load. By 19:00, I couldn’t stop yawning enough to read a sentence. I decided to give bed a try…and what a bad idea that was! All that happened was a short nap, some angry attempts at falling asleep and then a bunch of searching in the app store for the perfect apps for my books and schedule. Exciting, right? And now, I’ll show how awesome these apps are. Technology is amazing!

These will be my 3 main school apps. Last semester, I switched over to taking most of my notes on my iPad. It was a bit of a tough transition, but I’m really enjoying it. In fact, I’m noticing that I prefer how fluid the information is! Nothing I write is committed for eternity. It can be copied, enlarged, flipped, recolored – you name it!

Preview

iStudiez Pro will be my planner. It copied over my schedule from my calendar, so I didn’t have to input everything again. I’ll be using it to keep my study tasks organized.

Planner1

Ignore the “Doctor Appts” title. Need to change the name of the calendar 😛

Planner2

You can access each of the subjects individual to see the tasks assigned to them.

UPAD is a notetaking app, but I’ll be using it for my books. I’ve been using GoodReader until now, but really don’t like the interface. I wanted something as intuitive as Notability (see next), but needed a different program so that I can use them simultaneously. This one has a feature that makes it much easier to scroll through hundreds of pages, so it is actually much better than Notability when it comes to large files. It will allow me to highlight, take margin notes and take screen shots to input into my notes in Notability.

Books1Books2Books3

Last is my absolute favorite – and my lifesaver! Notability. I used this program all last semester and I honestly can’t recommend it enough. It has an iPad app as well as a MacBook version and they synchronize automatically over iCloud. Everything backs-up to Dropbox anytime I change a file, so I never have to worry about losing anything. I can take pictures and input them into my notes, plus take audio that follows along with any notes I make. I take all my notes directly into the program using my stylus. A little getting used to – but so worth it!

Notability1Notability

Here’s an example of how iPad note-taking trumps paper notes. This is from today’s internal medicine lecture. I wasn’t able to get down all the info in time and there were some complicated diagrams, so I just snapped a picture and drew directly on it. Saves me so much time (and confusion) later!

LectureEx2LectureEx1

Ok, only 5.5 hours of sleep ahead of me – let’s try this again…

Paris pics to come!!

Where Am I?

You are currently browsing the Studying category at Buda-B.

%d bloggers like this: