So close, yet so far

June 9, 2014 § Leave a comment

It’s the beginning of day 4 of “studying” for our last exam: biochemistry. It covers 3 semesters worth of material and we still set aside only 6 days to prepare.  I think we underestimated just how exhausted we would be after the anatomy exam. I’ve gotten to a point where I just don’t care any more (I care, I just don’t feel like I do). I’m going through the motions of studying, but I feel like I’m getting nowhere and am having such a hard time keeping focused. Exam period is the worst. It requires the energy and power of a sprint, for the length of a marathon.

Studyhours

Maybe our exhaustion has something to do with the almost 300 hours we’ve studied in the past 30 days?

I’m losing hope that I will be able to pass on Thursday. There is so much information and I don’t know if I have anywhere to put it. My brain and eyeballs feel like they are wrapped in saran-wrap that just keeps getting tighter and tighter. This makes me even more frustrated because the one thing I want is to be done with second year and I feel like I am just dragging it out. Things have gone well so far and there is just this one more hurdle to seal the deal. I want to sleep without feeling like I should be doing something else. I want to enjoy the beautiful summer days and read books that have nothing to do with school. I want to do a new art piece and sit at a café without studying. But this is the part where I have to remind myself that this is what I want to do more than anything. If I had the option 0f being where I am now and any other point in the past, I would choose this moment in every case. We’ve feared this exam period since we started medical school and now it’s almost over. We can do this last stretch!

Buddhaquote

Look over here! Look over there! BAM! Exam period.

May 17, 2014 § 2 Comments

I feel like we were cast into in a time machine that shuttled us through a rickety, roller coaster path from this past exam period to this one. This exam period is the monster. The first two theoretical based years are over and we are now to make the big leap to third year. Before that, we need to prove our knowledge of 2 years of anatomy (though, 4th semester was more review), 3 semesters of medical biochemistry and 1 year of physiology. We have 6 weeks and we are at the start line completely exhausted.

This past week was a total sprint through a series of last exams:

Monday: Last anatomy class ever and 9 hours of biochem cramming

Tuesday: Hungarian written midterm and biochemistry lab exam (given one of 22 labs we’ve done in 3 semesters and expected to write out a lab report on it)

Wednesday: 17 hours of physiology cramming (15 hrs studying and 2 hours worth of breaks)

Thursday: last physiology seminar test, physiology lab exam (oral exam based on all the labs we’ve done this semester) and then to close out the night, physiology competition.

physiocramming
Friday: Last physiology lecture and waiting for the physiology competition results

Come Friday, I was absolutely exhausted. In a perfect state of too tired to do anything but lay in bed but too wired to nap. We’ve been so busy, that I don’t even know what happened to these past 3 weeks. 3 weeks ago, Jannie and I made a study schedule – and now it’s over. Just like that.

As you know, competition studying didn't go as planned :/

As you know, competition studying didn’t go as planned :/

It’s been a bit of a struggling figuring out how to juggle everything. At the end of the spring semester, there is a series of competitions within each of the subjects. Passing the biochem or physio compeition give you exemption from the final exam and passing the anatomy competition can give you exemption from the practical part and/or histology part of the final exam in anatomy. Preparing properly for those exams, most likely means having to sacrifice something else in some other subject (except for those few genius individuals who can do it all). I really, really wanted to go for the physiology competition, but as time began to slip away, I realized that I had to make a choice: lab exams or physio competition. It was a hard choice to make and in the end I decided on the path that would give me guaranteed bonus points for my exams rather than gamble that I could pass the competition.

The lab exam for biochem is a bit of a hurdle because you have to pass it. We are given our first shot during the last week of the semester and if you don’t pass, then you will have to pass it at the final exam (which is not going to be fun with all the other information you’ll need to have crammed in your head). It felt impossible (and useless) to memorize 22 labs with 22 different theoretical backgrounds, methods, procedures, results and conclusions. On the morning of, I’d lost all hope that it would go well. All the values were starting to mix together and I felt as though things were simply slipping out of my head. Luckily, I got a topic that I knew well enough that I hadn’t even reviewed it as much as the others: Digestion of Lipids, determination of lipase activity. I was able to write down everything almost exactly as I had it in my notes, save for a maybe insignificant detail on my graph. Now I just have to hope that it is what they wanted.

Tuesday night and Wednesday were tough because I began to doubt my choice to go for the lab exam in physio or go for the competition. As I mentioned last semester, all of our lab work and weekly tests get calculated into bonus points that are added to each section of our exam. These are worth gold because they can help you pass a section if you are some points below. As there are 3 sections, you can get 3 x your number of bonus points added to your exam (so 1=3, 2=6, 3=9 and so on). If I passed the lab exam with a 5, I would get 5 bonus points, something that would make me feel great about my work this past semester. However, if I could accept 4 bonus points and not show up for the lab exam, I could do last minute cramming for the competition. So what did I decide? The lab exam. With a bit of a heavy heart, I decided that the act of showing up and being tested orally on my knowledge was the best option for me. And, as Skjalg told me Wednesday morning, “Bianca, you made a choice and you have to stick with it. Period.”.

The result? Seminar test did not go so well, but the lab exam did – so I got my 5 bonus points! As for the competition, I didn’t pass, but I was surprised at how well I did considering my lack of preparation. The test was set up as 40 open questions and 2 essay questions and we were given two hours. The essay questions were:

  1. Describe the homeostatic changes that occur with rapid transfusion of cold and hypotonic NaCl solution.
  2. What are the acute and chronic changes that occur in the cardiorespiratory system, cerebral circulation and in hemostasis at high altitude?

I stayed for the first hour or so. I answered everything I could and decided to leave when I noticed that my brain just wasn’t working anymore. These were the results, I’m limetree21. As you can see, I’m still a good 20-ish points off from having passed! That said, if anyone is reading this and considering doing a competition – go for physio! The questions were very fair and if you have the opportunity to review all the topics – even if only superficially – it’s possible to pass. L I N K went for the biochem competition earlier this week and then just randomly decided to review for the physio competition the day before. Good thing he/she did!

physioresultsSince I didn’t get much studying done yesterday, I have a hellish 5 days ahead. First exam is physio on Wednesday and there is A LOT to review. I don’t even know how I am going to do it yet…

Peek-a-boo

April 29, 2014 § 2 Comments

I’m surfacing from what has been a crazy past two weeks. After my last post, we still had a few days of Easter break left and in the week that followed, we’ve had 5 exams (well, two quizzes, 1 competition and two midterms).

My friend Stian and his boyfriend Kim and a couple of friends were here in Budapest towards the tail end of the break. Stian and I met in Oslo some years back through our mutual friend Marie and have been friends ever since. They arrived on Thursday, a day on which I was having a very hard time getting anything done studying, so I was very happy when I received a surprise text saying they were outside our apartment. We shared a bottle of wine and then headed out for a little tour of the neighborhood and then over to Gozdu court to find a place for dinner.

The forecast for that weekend was poor, so when I woke to sunny skies on Friday, I immediately messaged Stian to ask if they wanted to go on “the walk” (a certain route Jannie/Skjalg and I usually take). We made it into a little event by stopping at Culinaris on the return leg and then setting up a little picnic on the benches in front of Parliament. Culinaris is a fine foods shop that sells all kinds of amazing products, including American goodies (though not the healthiest) and things like lavender-infused olive oil, Madagascarian vanilla bean tea, and randoms like bacon jam (not for us of course!). Skjalg and I picked up guacamole, arugula pasta salad, quinoa salad and lemon-cilantro hummus from the deli, while Stian and Kim picked out quinoa salad, tropical fruit salad, spicy peanut butter, violet-infused strawberry jam and a selection of fresh, savory breads. For drinks we had coconut water, aloe vera water and diet A&W cream soda (which wasn’t as good as I remembered).  To take home for later, I picked up my absolute favorite black rice, perfectly ripe avocados (hard to find in Budapest!) and some pumpkin to make pumpkin protein bars. Here are some pics from the walk/picnic taken by Kim:

1941348_10152387516072174_4418460968442696080_o2014-04-18 12.59.30

On Friday night, we all headed out to Iguana for dinner and then to the amazing Cuban getaway La Bodeguita del Medio for drinks, talking and dancing (though beautiful Hanna did most of the dancing). That Saturday, Sunday and Monday were study days, which closed with a last goodbye dinner at Indigo. Tuesday morning, it was back to the grind!

This past Thursday, we had our physio seminar quiz on the autonomic nervous system (which I don’t think went so well, unfortunately), our lab quiz on electrooculography and at 18:30, the anatomy competition. At the end of the second semester of the year, one can participate in competitions within each of the subjects. The “prize” and conditions of the competition vary. For the anatomy competition during the first year, the winners were exempt from taking the semi-final exam. This year, since it is a final exam covering all the material of the two years, the winners will be exempt from the practical (specimen identification) portion and/or the histology portion. After this first round of the competition (the one we did on Thursday), 5 out of 75 will be going on to the next round, which will take place this week. I didn’t study for the competition (there was just too much, especially with physio on the same day) but I went anyway, just for the experience. The competition consisted of 150 identifications of structures within morphology, histology and embryology.

After making it through that crazy day, it was cram time! Or, continuation of cram time (welcome to second year!). On Monday (yesterday) we had a cleverly planned two midterms in one day (all the days of the week and all the weeks of the semester…and they need to be on the same day?). I thought it was going to be impossible. It wasn’t, but it wasn’t easy either. During Easter break, I managed to go through all the lectures and take notes to use during finals, but after that, I prioritized anatomy. There were many different ways people chose to handle the two-midterms-in-one-day thing. Since we only have to pass one anatomy midterm this semester to be accepted to the final, most of those who passed the first one decided to focus only on biochemistry. The score of your biochem midterm will be added as bonus points to your final exam score, so many people felt it was more beneficial to get those points. For me, anatomy is a much bigger foe…I can’t even begin to describe the anxiety I feel about it. So, instead of gunning it for the biochemistry bonus points, I decided to focus on anatomy and use it as an opportunity to prepare for the final exam. At the end of June, we’ll see whether I made the right choice or not 😉

My anatomy midterm was extremely smooth, except for the nerves that manifested as an extremely shaky right hand. I was examined by a teaching assistant of the same examiner I had for my last semi-final in anatomy. This midterm covered topography of the ventral regions of the limbs and thoracic and abdominal cavities. Most of the questions I was asked were possible for me to answer because of the studying I have done these past few weeks. That gave me all the confirmation I needed that I had prepared the right way – something that is gold to a med student, since we are almost always doubting our methods of preparation.

The hours after the anatomy midterm were quite brutal. I really thought that I would be able to get in 6 hours of effective review before the biochem midterm, but my post-anatomy brain just wasn’t in the game. I had to really force myself to sit there for hours and load up my short-term memory – and that is the least effective way to study. I was able to answer most of the open questions, but I think I might lose on the multiple choice, of which I had to completely guess on about 12 of 25 of them. It was a bit of a hard pill to swallow. Failing anything is never a good feeling, but I just have to suck it up and keep going. No use in feeling sorry for myself!

So, what am I up to now? Well, with the last anatomy and biochemistry midterms done, I can go hardcore physio. I’m not a big fan of putting all my eggs in one basket, but I have my sights set on the physio competition on the Thursday of the last week. The only other subject I will be required to focus on in that time will be biochem. At the end of each semester, we have a lab exam where we are given one lab from the semester and have to write a sort of report about the lab. This semester, since it is the last of biochem, our lab exam will include all the labs we have ever done. I honestly don’t understand why we have to do all of them, especially when we have already been tested on the previous semesters’ labs, but cést la vie.

The physio competition will include 40 open answer questions and two essay-type questions. From what I understand, only the top 3-5 students are chosen and will be exempted from the entire final exam. It’s a big goal, but there’s no harm in trying!

Ok, off to a long day of Hungarian, biochem and physio!

Spring Forward

March 30, 2014 § 4 Comments

It’s a beautiful Sunday morning and I am up and at ’em! Since my last post, things have been quite hectic. After the anatomy midterm on the 17th we jumped straight into cramming for our weekly physiology tests. That week in physiology we were tested on the adrenal gland and calcium metabolism. We’ve just finished up the endocrinology series and are now starting neurophysiology. By the that Thursday night, we were already exhausted – but we had to keep going! Monday the 24th was our biochemistry midterm covering the following topics:

  • Na+,K+ ATP-ase I. The permeability of cell membranes, P-type ATP-ase. Structure of Na, K-ATP-ase
  • Na+,K+ ATP-ase II. Na, K-ATP-ase isoforms. Regulation. Secondary active transports. Na-H exchange
  • Chemical neurotransmission. Cholinergic neurotransmission. Biosynthesis of acetylcholine, receptors, acetylcholine esterase. Molecular mechanism of exocytosis
  • Noradrenergic neurotransmission. Biosynthesis and metabolism of norepinephrine. Synaptic uptake
  • Molecular mechanisms of adrenergic, dopaminergic and serotoninergic neurotransmission
  • NO: Regulatory role of NO. Nitric oxide synthase. Guanylate cyclase. Molecular effects of nitric oxide
  • Glutamatergic neurotransmission. Synthesis, transporters, receptors. Biochemistry of Parkinson disease
  • GABAergic neurotransmission
  • General properties of ion channels. Methods for studying ion channels.
  • Structure of the K+ channels. Methods for studying ion channels. The molecular mechanism of gating and permeation.
  • Biotransformation I
  • Biotransformation I

Rest then? Nope! Luckily, the exam took place at 19:10 in the evening, so we didn’t have to feel guilty about taking the rest of the night off afterwards. The hours before the exam were spent at the library. We were bad and skipped anatomy so that we could be at the library from 9:00 in the morning until just before the exam. After the exam, we went for drinks and dinner at Tiki Bar. It was nice to sneak in a little break, even if we did have to cut it short so that we could get up early for school the next day.

From Tuesday we were on it for cramming for that week’s physio tests. Our seminar test covered the pancreas and whole body metabolism and the lab test covered the glucose tolerance test, which can be used to diagnose diabetes. Three students had to fast for the test and at the beginning of the lab consumed 75g of glucose dissolved in 250-300ml of water. We then measured their blood glucose level over the course of two hours.

By the end of Thursday night, I was completely beat. In addition to the exhaustion I felt after cramming for the recent exams, I somehow caught a cold. It full-on attacked me while we were studying Wednesday night (Skjalg too!). It was so hard to push through to Thursday night but somehow I did it. I took Friday off and Jannie came over and we watched Grey’s Anatomy and played playstation.

Yesterday was also a little bit of an easy day. I spent the morning organizing my study plan for the next month or so. Finals period is RACING towards us and I want to conquer the anxiety as much as I can before it settles in for good. My plan is ambitious, but I think that laying it out the way I did will help keep me accountable for what I am to do that day. So far I’ve worked in both lab exams, physio and biochem, the next anatomy and biochem midterms (which are going to be on the same day!) and a bit for physio. There is still a lot I am going to need to add….it will be interesting to see how it changes with time. I’m planning on doing the physio competition at the end of the semester. It is during the last week of school and covers all of the material we’ve learned in physio. If you pass it, you are exempt from the final exam – so it is well worth it!

StudyPlan

And here is my plan for this weekend. I managed to do everything except the last two anatomy topics, so those will be moved to today.

WeekendTasks

Second to Last Anatomy Midterm: Check!!

March 17, 2014 § 2 Comments

This morning we had the first of the two anatomy midterms we will have this semester. As I’ve mentioned before, anatomy has been a bit of a trouble child this semester. It is only 3 credits (so we only have 1 practical and 1 lecture a week) and yet it demands so much. At this point, we have covered everything and this should all be review…but it’s not that easy. I don’t even know how to describe just how much we need to know.

We’ve been covering anatomy superficially these past weeks and after Thursday’s physiology tests, we were ready to go hardcore anatomy. Between Friday afternoon and early Monday morning, we studied for a total of 37 hours. For this exam, Skjalg, Jannie and I decided to go through the material together. It made for a fun weekend, albeit slightly stressful. We presented topics on the giant white board, made up funny ways to remember things and peppered each other with spontaneous quizzes. In my post-midterm bliss (aka pure exhaustion) it’s hard for me to recall the horrible anxiety that slowly took root over the weekend. For that, I’m thankful.

2014-03-17 18.36.10

Anatomy midterms are done orally and in front of the other members of our group. We have a small room (enough for maybe 20 people comfortably) with three long metal cadaver tables in the center and large metal cases for the specimens along the walls. There is usually 1 examiner in the beginning and then others will pop in during. They usually start at the bottom of the class list, which means I am the first to be called up. Sometimes, the examiners will examine several students at a time, but it really varies. Those that are being examined are assigned a spot/region at one of the specimens or asked to make a drawing on the chalkboard. Some examiners begin asking questions right away, whereas other give you a region to focus on and then give you time to collect your thoughts before they start.

This morning, we piled into the corridor outside the dissection wing as we have many, many times before. I spotted a certain professor outside our room and my stomach dropped a little when I realized he was probably going to be our examiner. Little stories I’d heard about his exams began to creep forward into my consciousness. I halfway accepted my fate and pushed the thoughts away as I slid on my lab coat. He came in and told me to prepare the specimens. As I was laying out the last one, my name was called. No time to let the nerves build up.

My first task: draw a frontal section of the larynx. This was something I had not practiced drawing this weekend. I looked it over for a moment in a textbook, but didn’t expect that we would get asked it on our exam. Luckily, I was able to piece it together. I was left there for about 10 minutes while the original examiner and another examined other students. In the time that I was up there, I think one or two failed and one passed with a 3. Intimidating to say the least.

Larynximage005

Soon it was time to be examined on my drawing. I made some small errors in the drawing, but they were easily remedied. I was asked:

  • vestibular ligament
  • quadrangular membrane
  • aryepiglottic fold (what is the superior border of the quadrangular ligament?)
  • thyroid cartilage
  • cricoid cartilage
  • triangular ligament (what is the vocal ligament the border of?)
  • transverse and oblique arytenoid muscles (which muscles bring the two arytenoid muscles together?)
  • epithelium types of the different parts of the cavity
  • internal branch of the superior laryngeal nerve, direct branch of the vagus nerve (innervation of the mucosa superior to the vocal folds)
  • inferior laryngeal nerve, the terminal branch of the recurrent laryngeal nerve, of the vagus nerve

That’s all I can remember of that part for now. I was then asked to look at a specimen similar to this (of course, mine was a real cadaver 😉 ) and it was still attached to the torso:

lingual1

 

I was asked (at least what I can remember):

  • anterior belly of the digastric and innervation
  • posterior belly of the digastric and innervation
  • inferior alveolar nerve, origin and fibers
  • lingual nerve, origin and fibers
  • innervation of the mucosa of the tongue
  • innervation of the mucosa of the epiglottis at the extreme posterior of the tongue
  • thyroid gland and blood supply, including origin of those arteries
  • middle trunk of the brachial plexus
  • anterior scalene muscle
  • sternocleidomastoid muscle and innervation

Then he took me to a specimen that showed the sagittal section of the skull with the exits of the cranial nerves:

HN128

 

  • hypoglossal nerve
  • Dorello’s canal
  • abducens nerve
  • cavernous sinus – contents and location of the contents in the sinus

Despite a few little bumps, I made it out with a 4.5. I’m still in disbelief. Of all the scenarios I had imagined about the exam, this was not one of them. I’m not complaining either 🙂

After I got my mark, I was allowed to leave. Though Jannie had started after me, she was done about 5 minutes before I was. We met outside and then headed straight for the library. Why? Well, there is no time to rest in second year! Even after the heavy studying we did this weekend we have to keep going. On Thursday we have yet another round of physio tests (we have two every week, one covering lecture topics and one covering our lab that day). Can we rest then? Nope. Monday is our first midterm in biochemistry, covering neurotransmitters and their synthesis, transmission, etc., and fun topics like biotransformation. Then, the cramming begins yet again for next Thursday’s physio tests. It’s never-ending!

It’s almost 23:00 and this tired little med student is off to bed!

Third Semester: Check!!!

January 22, 2014 § 7 Comments

Which means: I’m going home to see my family!

At the moment, I’m waiting for my connecting flight in London. I’m beyond exhausted. I honestly can’t remember a time I was more exhausted than I am now. I’ve had 5, maybe 6, hours of sleep in the past two days and traveling might squeeze me dry. If I wasn’t so drained I would probably be able to feel the pure excitement and relief that should be consuming me at this moment. But nothing feels real! I feel like I’m I some sort of alternate reality or in the between.

I will write more when I have a chance. Typing on the iPad is not so easy and I didn’t bring my computer with me. But for now, we are done!!

Exam Period: At a Glance

January 18, 2014 § Leave a comment

I’m taking a little study break and thought it would be interesting to visualize this exam period by the amount of hours spent studying each day. Of course, everyone has different study techniques. Mine is pretty much: get up, study, go to bed, get up, study, etc. I’m really bad at taking time to do anything else. Skjalg has been really good about getting out – he’s even been going to CrossFit classes 4 times a week. I wish I could relax the same way that he can. I will say that he has rubbed off on me a little over the years…at least I take breaks now.

I use an app called TimeSheet when I study to log my hours. I’ve mentioned in several times before. It’s a really great tool for getting an idea of how much time certain tasks take and how much time is really needed to study for something. So, I used the app info to add the total study hours to a calendar. The numbers represent the amount of hours from when I sat down to study to when I stopped (so they include break time, which usually totals an hour or so a day…sometimes more).

This might give you a better idea of what we go through during exam period (and explain why we are so stressed and exhausted!).

ExamPeriod1 ExamPeriod2Alright, break over, back to reviewing this amazing topic…

Cholesterol transport

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