February 11, 2017 § 8 Comments
It’s almost 3 in the afternoon and I’ve only been awake for 2.5 hours. Even still, as I lay here in bed writing this, I’m considering taking a nap (Edit: it’s now 19:00 as I continue writing this… I fell asleep for another 3 hours).
This week was scary, amazing and all-consuming. Almost everything I did was outside my comfort zone. There were some really high high’s and some very low low’s. Everything is changing now. We are nearing the end of this giant, life-altering chapter of our lives and that fact sinks in deeper and deeper with each passing day. I feel like I’m standing in a giant room with every door and window open; time is running out and I need to escape this room, but I don’t know which door or window to go through.
Now, let’s take you through the past week:
- 8:00-12:00 – Hematology practice on the Buda side
- Leave an hour early to make it to anatomy on time
- 12:00-13:30 – Teach anatomy
- Colleague is sick, so take on his class as well. Come up with a plan for making the practice useful for your now 25 students.
- Teach cardiac embryology and hope that they at least understood half of what you were saying.
- 13:30-14:00 – Try to help your students with a scheduling problem they have with PE and anatomy.
- 14:00-15:00 – Last minute preparation for public health (PH) research presentation
- 15:30-17:30 – PH research presentation
- Mock presentation of your research for the entire department
- Note down critiques and tips and answer any questions
- Sit in on the presentations and critiques of two other Hungarian students – all in Hungarian
- 17:30-18:30 – Get home and eat dinner – you’ve only had two protein shakes so far today
- 18:30-22:30 – Work on changes to your PH presentation
- 8:00-13:00 – Hematology practice
- Try to pay attention and learn something, but you are 18 people crammed into a small room and you can’t think about anything other than your research projects.
- Leave early with Amir to work on surgery research project. Note to self: make-up missed session later (just another thing to deal with).
- 11:00 – Find out you’ve been rejected from the 6th year program in Stavanger, then immediately after, get a call from your boyfriend that he was accepted. Feel extreme happiness and sadness simultaneously.
- Ignore your emotions so that you can focus on your research project
- Best friend pushes you to talk about it. Feelings and fears about your future as a doctor rush forward. Freak out about the future for 30 or so minutes.
- 12:00-22:30 – Surgery research project
- Literally 10.5 hours of constant work on your presentation. Remember all that statistical analysis you did in December when you wrote your abstract? That doesn’t make sense anymore. Re-learn it and do it again.
- 22:30-02:00 – Home to finish up project while talking about Stavanger with boyfriend
- 02:00 – Submit presentation to advisor
- This still counts as Tuesday night, right??
- 8:00-13:00 – Work on presentations
- Make final changes
- Look up any articles/data needed for any potential questions about your research
- 13:00: Find out that you need to attend the laparoscopy competition on Friday and need to find someone to cover your classes
- Luckily, one of your TAs is a close friend and amazing human being! (Thank you, Marianne!)
- 14:00-15:00 – Surgery research presentation for your advisors (one of which is the head of the department)
- 15:00-16:00 – Watch 4 sessions of the Hungarian student conference while waiting for your public health advisor
- Get smacked in the face with the reality of what is going to happen to you tomorrow.
- 16:00-16:30 – Meet with public health advisor to go over finishing touches on presentation
- 16:30-17:00 – Rush into a store to find a suit jacket for tomorrow
- 17:00-18:45 – Amir’s place to work on changes to surgery presentation
- 19:30-02:00 – Work!
- Finalize both presentations
- Practice presenting
- Make quizzes for anatomy class – and start grading quizzes from Monday!
- 07:00 – Get ready and practice presentations
- Realise you’ve made a mistake in your presentation and go through the data again. Make the change in your presentation.
- 10:00-11:00 – Attend presentation by Thieme at the anatomy department.
- 11:00-12:45 – Practice presentations at conference location
- 13:00 – Session starts!!
- 13:35 – Surgery research presentation
- Maximum 10 minutes
- 5 minute question section, where jurors can ask any questions regarding your work. Some of your questions:
- How did you account for the potential bias of those that volunteered for the experimental group (i.e. that they were already interested in surgery as a profession and therefore likely more skilled)?
- Do you plan to redo the study and if so, what measures will you take to increase the statistical significance of your results?
- What role do you think gaming systems play in the development of laparoscopic skill and technique?
- 13:45 – Rush out of room with Marcus (a fellow 5th year student presenting with you in the next block)
- The block for your other presentation is already halfway done and you have to sneak in and upload your presentation during the break
- 13:50-14:50 – Observe presentations of all other students of your block.
- Marcus does an amazing job and gets more questions than you’ve seen anyone get (he worked on a study comparing different EKG readers).
- 14:55 – Public Health research presentation
- Maximum 10 minutes
- Get a little thrown off when one of your animations messes up and shows Dresden and Munich as being in the middle of the North Sea. Marcus tells you later that you made a nice save.
- 5 minute question section, where jurors can ask any questions regarding your work. Some of your questions:
- What explains the age difference between the analysed subgroups?
- How did students specify their desired specialty?
- Do you have similar statistics showing predictive factors of other specialities?
- Maximum 10 minutes
- 15:15-19:00 – Pictures, celebrate and nap before the closing ceremony.
- You didn’t finish grading the quizzes from Monday, so you have to do it while celebrating with your friends at Spiler.
- Luckily, your friends are awesome and split the grading with you. Cocktails and grading for the win!
- 19:30 – Closing ceremony
- On the way here, Skjalg brings up how he thinks you could win. You tell him to stop bringing it up because you don’t expect it and don’t want to start thinking about it. You’re just happy with having presented.
- The ceremony starts and people keep asking you what section you were in. You honestly don’t know. Getting through the day was literally the only thing on your mind.
- You recognize a name in 3rd place of one of the sections. Skjalg, Amir and András (your advisor) get antsy. Second place is announced and you see your name flash across the screen as it is read out loud by the conference director.
- You walk up, get your prize – in complete shock – and then return to your friends.
- The next section results are read. You’re busy looking at your prize and diploma – still in complete shock. Suddenly, your and Amir’s names are read out loud for 1st place.
- Back to the front you go – is it possible to be more in shock than to be in complete shock? You and Amir are both so surprised that it makes for one of the most endearing and genuine moments.
- 22:00 – Bed
- Have you ever been this tired before? Probably, but it doesn’t feel like it.
- 06:00 – Suturing practice
- Laparoscopic competition is at 8:00 and you haven’t practiced suturing in a long time
- No chicken breasts or bananas present….this kitchen glove will have to do!
- 8:00 – Laparoscopy Competition
- 1st round – Peg transfer: you do great during warm-up, but when the comp starts, you drop your rubber tube twice! This adds 40 sec onto your best time and puts you in 12th place.
- 2nd round – string 5 pieces of straw onto suturing thread: you drop one of your straw pieces (again!)
- You (somehow) manage to snag 4th place. Your amazing boyfriend rocks it with 3rd place!
- 13:00-17:00 – Last day of haematology practice on the Buda side
- 17:00-18:00 – Psycho-cleaning of the apartment
- 18:00-midnight – Indian night with your friends!! And a perfect way to close a hectic week.
Click here for all of the abstracts by presenters at the conference.
- I was rejected, and Skjalg accepted, from Stavanger. This means that I will be here in Budapest for 6th year and have to find a new place to live (for myself). Skjalg will be in Stavanger for the entire year and will come back to Budapest every few weeks for exams.
- I won 1st place together with Amir for our surgery research project and 2nd place for my public health research project.
- Skjalg won 3rd place in the laparoscopy competition.
- I have amazing friends from all over the world.
I’ve slept for about 16 of the last 24 hours, which is a pretty good indication of how I am feeling right now. This week was a heavy one. A really, really heavy one. But in the end, I am so happy for it. It felt so good (afterwards) to have pushed myself through something I never thought I could do. I’m happy that I have the strength to throw myself in new directions and the support system to care for me when I don’t quite make it.
October 11, 2016 § 2 Comments
It’s been a while since I last wrote and I have to say I’ve missed it a lot! The rest of August was packed with work – we even worked on the day that we left for the flight back to Budapest. It will all be worth it when we get our pay checks, but it was quite tiring then!
We started school the day after we got back. This should be a calm semester – we have the block system now, so we only have one subject for 1 or 2 weeks at a time – but I don’t think I’ll ever experience “calm”. The reason my semester isn’t calm has to do with something I never could have imagined happening: I’m teaching anatomy!
Along with my friends Dushyant and Amir, we are the three 5th years students who each have our own group in anatomy. It’s a huge honor and I feel so lucky to have been offered this opportunity. It’s also A LOT of work! I teach 3 classes a week (one histology and two in the dissection room) and outside of that I spend maybe 10-20 hours a week preparing/reviewing for the class. This semester we are focusing on the locomotor system (all the muscles, movements, nerves, vessels etc. of the upper limb, lower limb and thorax).
I absolutely love apps/technology/organizing and teaching this class is giving me the chance to let my technology freak flag fly high! In order to share useful sources, links, notes etc. with my students, I’ve created a page on a website called Trello. It’s more of a project managing site for companies, but I feel that it also works really well for teaching.
I re-organized it last night (one of the keys to success is constantly evolving your tactics, right?), so now it shows each board by topic. Previously, I had organised by week, so that they could follow along during the weeks of the semester. With midterms approaching, I think it is more efficient to have everything in one place.
This is how the main page of the Trello account looks:
When you go into specific boards, you can see that different topics or weeks are divided into separate lists. Each list is composed of various cards.
When you click on a card, it will open up to a smaller window and show you the details included in that card. For each histology slide, I include links to videos or websites covering the theory, details from the new histology guide written by the department, details from the old histology guide (which I feel has more detail and information) and then at the end, a picture of my own notes for that slide.
In addition to Trello, I use the website Memorang for creating flashcards. I’ve used this app before for previous courses and absolutely love it. I do prefer traditional, hard copy flashcards, but the benefit of this site is the algorithms (if you get a card wrong, it intermittently repeats it until you hate it) and the statistics (it gives you percentage progress with each card and with the deck). My students have access to the cards and I can see the top students on the leaderboard for the different sets.
On the online version of the site, there are different testing methods – which can be really great when you are tired/bored with studying and need a little kick.
I use the multiple choice option the most, but the traditional flashcard version is great when you need to first learn the material.
Another program/app that I’m using – or will start using today – is called Socrative. I really like how online quizzing systems can be integrated into the classroom/lectures. I’ve heard that one of the pathophysiology teacher has started doing it in his lectures and one of our internal medicine teachers did it during one of her presentations. It’s such a great way of keeping students engaged and interested. I’m not sure how I will integrate it into my practical classes, so for now I am using the site to arrange online quizzes that the students can do at home. My friend Amir and I have created almost 100 questions that we will launch in two rounds. My group will have their first quiz today and their second on Tuesday evening.
I will open the quiz for 1.5 hours and can track their progress throughout that time. At the end, I can download reports that are either (a) question specific or (b) student specific, which the students can then print out and use to study from late.
In addition to teaching, I’m doing research with two departments: Department of Surgical Research and Techniques and Department of Public Health. If all goes well – which I’m sure it will, after a lot of hard work – I will present my work in both departments at the TDK conference (Student Research Conference) in February. I had a really great experience with my 2nd semester public health professor and he has offered to be my thesis advisor. There are a couple of potential projects I can consider for my thesis (which must be completed by the end of 6th year, but which should be started – at least – by 5th year). I won’t tell about any of them yet – don’t want to jinx myself! With so many different departments, possible topics and potential thesis themes and advisors, I feel lucky to have a place to start.
I’d hoped to make this post longer and a bit more informative, but at this point I just need to press “publish”! I’ve sat down to write a new post countless times in the past two months and always get interrupted by something :P.
Tomorrow I will be examining 1st year medical students for their first midterm (covering the entire upper limb) all day. There are exams at 8:00, 10:00 and 14:00 and I’ve agreed to be there for all of them. It still amazes me how different things are now and how crazy it would be to go back and tell my 1st year self where I am today!
To get an idea of what the students need to know for their exam, check out the checklist I made for my group. That’s a lot of new vocab to learn!
Ok, off to Memorang flashcard land I go! Meanwhile, my students are finishing up their second quiz. I love being able to follow along live. The quiz Amir and I made is really, really tough (designed to make them think and use their knowledge), so I’m not too worried about the incorrect questions.
June 7, 2014 § 5 Comments
Thursday marked the culmination of 4 semesters of anatomy. It was a day I’ve dreaded since I first learned of its existence, a battle I feared I would never overcome. When I started anatomy in the fall of 2012, I was completely blindsided. It required an entirely different language, a different way of looking at things, of understanding how things were related to each other and how the physical laws apply to the body. We have come so far in our two years here and the one class that has been with us throughout this entire process is anatomy.
With each semester, I learn more about myself as a student. I evaluate, I analyze, I critique, I evolve. That said, many, many changes have been made since I started Semmelweis. This was what I feared. I feared that the apparent holes in my knowledge from those first months would hinder me now. That I wouldn’t have time to fill in the knowledge I lacked. During the first semester, we covered the whole of the locomotor system. That includes all of the bones, ligaments, muscles, vessels – you name it. I remember having such a hard time remembering where all the muscles originated from, where they inserted, which action they evoked at which joint, which artery supplied blood to them, which nerve innervated them, which group of muscles they belonged to and which class of muscles they fit based on their structural characteristics. It felt like just too much to ever learn.
What I didn’t realize was that, in the semesters that followed, I would develop a way of thinking, a way of connecting themes and processing massive amounts of information, that would allow my to fill in these holes without issue. Although I made up for the lack of knowledge later, the anxiety remained. There is an unbelievable amount of information that we are expected to know for anatomy. Skjalg’s professor mentioned to him that the anatomy program here is one of the most, if not the most, comprehensive anatomy programs in Europe. At this point, we know everything about the anatomy of the human body from the organelles of the cells out. We’ve studied all the organs at macroscopic and microscopic level and how they developed in the embryo. We can describe exactly where they are localized in the body, group them by similar function, developmental origin, microscopic structure, you name it. We have learned the entire healthy human body, and to such levels that even Google can find only one result:
The days leading up to the exam were terrifying and the hours before were just short of excruciating. Jannie and I alternated between fits of tears and panic and Skjalg played the level-headed middle man when he dared. We gave ourselves 13 full days to study. We knew it was a lot of information to process and repeated to ourselves that we wouldn’t be able to go through everything, but I don’t think we ever really accepted it, at least not until we were forced to. As the days dwindled down in number to just two or three, and we realized that we really wouldn’t have time for everything, the anxiety began to magnify with each passing minute. I tried my best to maintain my composure, but it got harder as my conscious flagged more and more topics I didn’t know well enough. The topic list was 300 topics long. On top of that, there were 100 histology slides (microscopic anatomy) that we needed to be able to identify and explain. It just wasn’t possible.
Here are the topic lists, if you’re curious:
By the end of the 13 days, we’d studied 186 hours (167.5 of study time, 18.5 of break time). And yet, we still felt as unprepared as we’d ever felt in our lives. We did our best to stay positive and enjoy ourselves. This included me sneaking pictures of Jannie and editing them, us wearing motivational post-its on our foreheads, random dance breaks, balcony talks, hot cups of tea and shooting evil eyes to people on the street (to anyone NOT studying).
On the morning of the exam, I found it hard to get anything into my head. On the verge of a panic attack, I decided to go for a walk, rather than wake Skjalg up and expect him to usher it away. I’ve always found water calming, so I headed straight for the river. It’s not quite the oceans of California, but it serves as a decent substitute. I settled on a flight of concrete steps leading into the water. I stared at the green, opaque waves and attempted to wrangle in my thoughts. I accepted that I was unprepared. I accepted that I would fail. I accepted that I would dust myself off and keep going, no matter the outcome. As waves crashed against the steps, I found a sort of peace within myself. The panic settled and I made the trip back home, to cram in as much as I could in that final stretch.
As we made our way to the anatomy building, I noticed a sort of finality to every step we took, every turn we made. This might be the last time we walk down this driveway. This might be the last time we walk through this doorway. This might be the last time we climb these steps. I brushed away each thought as it creeped into my mind. Nonsense to think of such things before a final you are so sure you are going to fail…
We locked our things in the second floor lockers and then waited at the base of the giant staircase. There were about 15 of us examined that day and we were examined in the 100 year-old lecture hall, part of a long-standing tradition. Here is an excerpt taken from the anatomy homepage, ana.sote.hu.
The final anatomy exam is a great tradition of the department. This has been changed substantially over recent years – the current form of the examination was introduced by the late professor Szentágothai in the sixties. The majority of the final exams takes place in the lecture hall which enables us to provide for the traditional framework, some solemn atmosphere and openness of the examination. The openness for the students participating in the exam provides for a double goal – on the one hand it ensures the clarity and fairness of the exam, on the other hand, it helps reduce anxiety and inhibition. For this is one of the biggest and most difficult examinations of the medical studies, which is mystified by many. The 10-15 students taking the exam on a given day answer questions of a panel of professors. Each student is dealt with by three examiners: one concentrating on macroscopic demonstration and dissection, another on the histological specimen demonstration and the third conducts the oral examination. Students also have to perform minor dissecting tasks during the exam. A given length of time is provided for preparation of the microscopic exercise and the oral examination. The oral exam comprises six questions on slips of paper picked by students. The list of all questionson the paperslips is disclosed in advance. Students are graded in each phase of the examination and at the end of the day the scores are aggregated to form the mark assigned for the anatomy final exam. The examiners participate in each phase of the examination. The examination takes place in a cycle with the sequence of the phases fixed. Where a student fails in one phase, his or her examination is stopped. The examination may be repeated after 10 days. About 20-25 percent of students fail in the first examination but only 5-10 percent has to repeat the semester. The majority of these students fail in more than one subjects. The average of the anatomy final exams – 3.0-3.2 (English program mean )- is considered as acceptable.
The exam was over before I knew it. I remember random details, but not the entire picture. I remember worrying about whether or not they would supply gloves and then somehow picking a lab coat that had about 6 pairs of them stuffed in the pockets. I remember worrying that my knees would give out when my name was called. I remember my heart stopping, just for a moment, when I heard who my practical examiner would be (the same one I’d had for my last midterm). I remember feeling the anxiety slip away slowly as I watched others during their practical exams, as I watched the professors wait patiently for them to answer, guide them through tough points and sometimes even laugh or smile. I remember floating through my practical portion on complete auto-pilot, anticipating an obstacle that never came. It was seamless and fluent. I felt respected for my knowledge and I wasn’t chastised when I made a small mistake. I was given an opportunity to correct it and then given positive feedback. Absolutely nothing like the horror stories I’ve dreamt up these past two years.
When I passed the practical portion and was told I could move on to histology, I began to get my confidence back. I’m still here, maybe this is possible! But then I realized that it depended on my slides. When I saw them – even before I looked at them with the microscope – my confidence grew stronger. One I could identify from 3 feet away: glans of the penis. It has a characteristic large outer circle filled by an inner smaller circle – a slide that I’d studied just that morning. The other I was able to recognize after a few seconds at closer glance: endochondral ossification (the formation of bone from cartilage in the finger of a fetus) – a slide I’d studied intensely last week. When it came time to present my slides to the second professor, I returned to complete auto-pilot. I made sure to present it in the same way that I had recognized which tissues they were. Half of the exam is your ability to present your knowledge, the other half is the knowledge itself.
Suddenly it was on to the theoretical portion. This was where I started getting nervous again. This was where I felt least prepared. There were 300 topics divided into 50 cards, 6 topics each, plus 1 cell biology topic. One wrong choice and I would have to do it all over again. I drew my green and tan cards and reported the numbers to the attendant professor. I was then given a few sheets of blank paper and told I could take a seat to the far left. I peaked at my topics on the way. There was one I was 100% sure of, three that I was 50% sure of, two that I would have to figure out completely on the spot and one that I knew almost nothing about. The one thing that made me feel like there was hope, was that I had chosen the topic card matching my favorite number: 21. A funny note here: one night last week, I went through the topic list and highlighted in pink all of the topics that I felt I knew nothing about (horrible thing to do before bed!). My plan was to focus first on those topics and then on my “need to review” topics marked in purple. This is my topic card with the highlights. I never got around to reviewing them before the exam. Just goes to show how little confidence we have during exam period – and how little we can trust our judgement!
I filled up my blank pages with as much information as possible. I was going to throw everything I had at those topics! Towards the end of my preparation time, I looked at the examiners that were left and tried to determine who would be the one to exam me. My own professor was there and we cannot be examined by our own professors, so he was out. Four left. Minus the two I had for the previous portions. Two left: the head of the English program of anatomy and the same professor I had for my last semi-final. Since we are only supposed to be examined by each professor once, this left the head of the program. But it didn’t end up that way! “Fiorentino, Bianca. Oh, it’s you! Hello, again.”
The theoretical portion went more or less smoothly, but no auto-pilot for this round. I was surprised at how much I was able to recall with some prompting – in addition to what I had already noted down during my preparation time. I’m a visual learner, so I made plenty of drawings and I think that helped present my knowledge. English being the professor’s second/third/fourth language, it’s always beneficial to communicate through visuals. In my opinion, my weakest topic was neuroglia. It’s not a difficult topic, but I haven’t touched it since early January. Luckily, I was able to talk my way through it. My examiner was actually my co-professor for histology 3rd semester, and with a little prompting, I was able to recall the drawings he’d made.
When he started to talk about some anonymous evaluation I needed to fill out, I had no idea what was going on. I asked him if I’d passed and he seemed a bit taken aback and laughed, “Yes. Of course you passed.”. That feeling…that little rush of disbelief and relief…there is nothing like it.
We had to wait in the corridor while the others finished up. After all the students are examined, the professors collaborate and determine the grades of each individual. The room was filled with such a mixed array of emotions, from ecstatic phone calls to family, shrieking girls and hugs, somber disbelief and complete lack of emotion (me – I was in such a state of disbelief that I felt nothing, it didn’t even hit me that we passed until I started writing this blog post). Out of the almost 15 that started the exam, 3 failed: 2 during the histology portion and 1 during the theoretical. At about 16:00, 3 hours after the start of the exam, the rest of us were called back into the lecture hall for the final results.
The professors stood in a row as we filed into the room. The program head gave a little speech about our exams that day and welcomed us back in the fall as teaching assistants. She then began to call out the names of each individual, followed by their final grade. Each person stepped forward, collected his/her index, was wished congratulations and given a final handshake. As the grades were read out loud, my desire for a 3 or 4 grew stronger. Now that I knew I’d passed, I didn’t want to just pass. When my name was called, I went into complete shock. “Fiorentino, Bianca. Congratulations, it’s a 5“. In the moments that followed, all I could think or say was, “I have no idea how that happened.”.
To celebrate our success, Martha, Jannie and I met with Martha’s fiancé and some of his friends at a local bar for some celebratory beers. After that, it was home to bask in the post-exam bliss.
That’s all I can reflect on for now. I can’t believe it’s over…what an amazing feeling it was to come home and put all of this away. Bye, bye anatomy!
June 1, 2014 § 3 Comments
Day 10 of cramming for this week’s anatomy final and we have logged in 127 hours of studying time so far. I’m battling greatly with periodic surges of stress and anxiety and trying my best to keep positive, to not let the stress take over. This exam is huge. There is no way I can prepare well for everything and that is not easy for me to accept. We are doing absolutely the best we can and that is all that matters. Sometimes I catch myself thinking that I should have done things differently these past two years, that I should have studied more or better. To push those thoughts away, I repeat a Maya Angelou quote in my head, “I did then what I knew how to do. Now that I know better, I do better.”. There are so many factors I can’t control and rather than focus on those, I need to keep my head up and move forward.
The exam will last about 3 hours. There are 3 parts, each with a different professor. If you fail a part, you fail the exam. The first part is what they call the Organ Walk. We will be led through final specimens and be asked to identify various structures. The second part is histology, where we will receive two of the 100 slides we’ve gone through during anatomy and will be expected to identify the organ/tissue and discuss any theory about it. The third part is the theoretical part, where we will draw a card containing 6 of the 300 topics on our topic list.
I’m getting too overwhelmed even writing about this. Back to studying I go!