The courageous venture into the unknown; the persevering conquer it

June 13, 2015 § 3 Comments

Last I wrote, I was preparing to tackle the monster that is the microbiology final. How did it go? To my surprise, really well! Afterwards, I was in a bit of a state of euphoria and while in that state, decided that I could handle moving my psychology exam to that upcoming Monday (so a week earlier than originally scheduled). That meant micro on Friday, psychology on Monday and internal medicine on Tuesday. I will write more about the exams themselves in another post when I have more time and energy.

I didn’t expect to be as burned out as I was after micro. I went to the library on the Saturday following my micro exam, but my brain was as good as useless. I wasn’t really able to get any studying done until Sunday night – and that’s when I started really feeling the effects of being so burnt out. But still, I pushed through as hard as I could. On Monday night at around 20:30 I sank into a deep panic and almost made the decision to not even go to my internal exam. I’ve never done that before and honestly never would – you never, ever know what is going to happen – but that is the closest I’ve ever been. After some motivating words from my friends Jannie and Amir, I made a plan to get me through the next 12 hours. I forced myself to read through the topics once and then mark the things I needed to memorize the following morning. I ended up “sleeping” from around midnight until 3:00 am and then got up to do whatever last minute cramming I could manage. The hours after 3:00 am were probably the worst I’ve had to endure this exam period. I felt like I’d pushed my body to the absolute brink and knew I would have to pay for it later. At least the sunrise that morning was beautiful.

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The exam ended up going really well – yet another surprise! – and with that I was on my way home to collapse in bed. From Tuesday afternoon until Thursday night, I wasn’t able to get out of bed. I suffered what was probably the worst headache I’ve ever had in my life and felt like I was going to faint every time I stood up. My brain had held my body hostage for weeks and now it was time for my body to hold my brain hostage.

I’m more or less recovered now, which is great because there is still one more exam before I can fully check out! I’ve been sleeping almost 10 hours a night, plus naps during the day, and even made it to the gym for an hour of cardio this morning. My head is still quite foggy, which makes studying a little difficult. Hopefully I can push through these last few days!

As for Skjalg, he conquered patho and internal this week and has micro, genetics, surgery and psychology ahead. I still can’t believe how crazy this exam period has been! It will be so nice when it is over and we can enjoy ourselves again 😛

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Blog post title: quote by Matshona Dhliwayo

Pathology: CHECK!?

May 20, 2015 § 6 Comments

Yes, you read that right: I AM DONE WITH PATHOLOGY! I had made such peace with the idea that I was going to fail and it didn’t happen!

The exam is split up into 3 parts, two practical and one theoretical:

Part 1: Autopsy

When I entered the locker room, I was told, “We’re all getting Dr. X”. Dr. X is probably my favorite lecturer, but I had been dreading getting him at the exam because I’d heard that he really likes to drill the students. He told us in lecture once that at the final exam, we should be able to do things like group all the tumors by their color. He is extremely systematic, a feature I love in a teacher and fear in an examiner. Having a systematic method while studying is great, but being forced to be systematic on the spot, in the context of a final exam, can be difficult.

I was so resigned to having to retake the exam, that I didn’t feel nervous at all. “I’m going to go in there, give it my best and really learn from the experience,” I told myself, “then I’ll know how to prepare better the next time around.”. We were called into the autopsy room in groups of 5. Awaiting us was a similar sight: the autopsy examination table displaying the different organs. I was actually able to find photo of the room online. The picture is quite small, but at least you get an idea. Usually, there are two or three mobile metal tables with the cadavers on them in the middle.

We were each assigned an organ and I ended up getting the one I wanted the least: the urogenital complex. It includes the kidneys, the prostate and the rectum of the patient. We were allowed about 5 to 10 minutes to look over the organs and note any changes. I got a little nervous at one point but quickly calmed down and told myself to focus on the pathology and not the outcome. Dr. X called my name and asked if I was ready. Now or never!

I described the morphological changes and answered any follow-up questions he asked. The organ complex showed pyelonephritis, nephrosclerosis and cystic lesions on the kidney, benign prostatic hyperplasia (I had to explain how I knew it was hyperplasia and not carcinoma), with compensatory hypertrophy of the urinary bladder (trabeculated) and adenocarcinoma of the rectum. There were some things I fumbled on, like the term hydropyonephros, but other than that it went very smoothly and I ended up with a 4/5.

Part 2: Histology slides and Specimen

For this part, we moved on to the histology lab. The room was full with students and examiners, so I had to wait for a few minutes outside. We were only 11 English students being examined that day and maybe 30 Hungarian.

I was escorted to a computer and the technician helped me log in and open my slides. My heart dropped a little because I hadn’t reviewed the slides I ended up getting. Rather than letting that get me down, I reminded myself yet again to focus on the pathology and not the outcome. In our last histology practice, our adjunct professor told us, “We know how hard the histology is, trust me. Sometimes, we don’t even know the diagnosis when we first see it. It takes a lot of time and a lot of practice. What we want to see is that you know how to use proper histological terms to describe the changes and that you can use your pathology knowledge to properly diagnose the tissue sample”. We have covered 121 slides in these two semesters and get 2 at random at the exam. The only information we are given is which tissue the the slide came from.

I ended up with one from the colon (coincidentally adenocarcinoma, just like I’d had in the autopsy room) and one from the lymph node. When I felt I was ready, I raised my hand for one of the examiners. Once she had seated herself beside me, I began describing the tissues, first describing how the normal tissue should look, then describing the morphological changes and finally linking those changes to my diagnosis. I made sure to sort of guide her through my thought process while showing her the slide at the different magnification levels. (These are screenshots of the slides, with notes written by the fantastic Charlotte.)

For my specimen (we get 1 out of a possible 60 or so), I got this beauty: the hydatidiform mole. It’s a tumor of the cells of the placenta. When I saw it, I actually got quite excited because it meant that a new study trick of mine had worked. For the past several weeks, I have kept a google image search of whatever disease I am covering theoretically open on my screen. That way any time I look up, I have a visual association with the disease. I remember this one well because it is so creepy looking. It looks like a bunch of grapes! If you want to see another tumor with “bunch of grapes” appearance, check out the female genital tumor: sarcoma botyroides (be warned!).

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Everything went very smoothly, save for some little fumbles, and I ended up with a 4/5 for the section.

Part 3: Theory

This is the part you have to worry about. You can fail the other sections and still pass the exam, but the theory is the big one. We ended up having to wait quite a while before we were called in to our exams. I don’t think I was called until around 12:30 (and the exam started at 8:00). During that time, I tried reviewing some topics and keeping calm. I just wanted it all to be over!

I was assigned to the same examiner I’d had for the semi-final. Her topics (each of the professors have their “topics” that they are especially adept in) are hematology and oncogenes. For the semi-final, I’d struggled with my topic on oncogenes and it ended up being the reason I’d gotten a 3. That was an experience I was hoping not to repeat at this exam.

When I pulled my cards, the smile quickly dropped from my face: (A) Autosomal Dominant Diseases, (B) Oncogenes and their role in carcinogenesis, (C) Inflammation of the Trachea and Larynx. (A) and (B) were both topics that I was not looking forward to having to answer – and (B) was a serious deja vu!

For topic (A), I talked about Huntington disease and Marfan syndrome in detail and then mentioned osteogenesis imperfecta and adult-type polycystic kidney disease. She wanted me to describe the genetic alterations, pathological consequences, clinical manifestations and treatment for each and then wanted me to mention familial hypercholesterolemia and its complications.

Topic (B) was where it went downhill. This was one of those topics that I kept telling myself I needed to commit to memory, but really only superficially covered. I’ve watched videos on it, taken notes and even have a chart hanging up in my study area. Still, my brain was coming up with very little of what I should know. I tried to recall everything I could, but she was quite picky on the topic. Had I memorized this table, it would have been perfect, because this is exactly what she wanted:

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From Pathoma (board review for pathology)

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Biancafied!

 

Towards the end of this topic, she seemed pretty disappointed and said, “Ok, let’s talk about lung cancer”. My teacher is the “lung” expert among the professors, so I had no problem listing out the classification of cancers of the lung. But then she asked me about the oncogene related to adenocarcinoma of the lung. When I couldn’t answer, she got a bit upset and told me that she is sure my teacher has mentioned it before and that I should know it. This is what she was referring to:

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She shook her head, waved her hands in the air and told me that the 3rd topic would determine my grade. No pressure! Topic C was easy, but that was it’s problem…it was too easy! It’s one of those topics that feels so unimportant that you kind of jump over it. Luckily, I’d looked at it the day before. Unfortunately, it wasn’t a juicy enough topic to showcase my knowledge. Here is the topic I got plus another one just to show how much of a difference there is between them!

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My topic above, versus another respiratory topic below. Which would you prioritize? 😉

I ended up with a 3, again. I’m a 50/50 mix of excited to be done and disappointed in myself. But I’m not going to dwell on it. I worked hard, I’ve learned a lot and I have a lot to learn. These topics will be repeated over and over again during the next three years, so I will have plenty of time to get them down.

A lot of growing and self-reflection accompanied this exam and I am stronger for it. I have some improvements to make but appreciate that I have the opportunity to do so on my own time.

Skjalg’s pathophysiology exam went well, so we celebrated with some wine down by the river.

Here are some snapshots from this past week:

My study cave :D

My study cave 😀

Joshua (the teddy bear that my mom got at my baby shower - yes, he's that old!) helped me review topics. Needed someone to explain everything to ;)

Joshua (the teddy bear that my mom got at my baby shower – yes, he’s that old!) helped me review topics. Needed someone to explain everything to 😉

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Spent the last day before the exam studying outside at Starbucks

Spent the last day before the exam studying outside at Starbucks. Nice to get out every now and then!

Our celebratory wine and snacks by the river 😀

Bye, bye patho!!!

Hello, pathophysiology!

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There’s a first time for everything

May 18, 2015 § 3 Comments

It’s 22:22 on the night before my exam and I am doing something I have never done before: going to bed. Normally I stay up until the physical pain forces me to nap for half an hour and then I’m back to studying before the nausea kicks in and I go for a second nap. Then, I get up, study more, shower and head to my exam. Sounds horrible and it is, it really is. And I don’t want to do that anymore.

I am not the least bit satisfied with my knowledge for this exam. There are a lot of topics I know well, but so many that I don’t. I could force myself to stay up all night like I usually do and hope that I cover that one topic I get on my exam but this time, I’m not going to. I want to feel good about passing this class. I want to feel like I worked hard, that I really knew the material and that I deserved to pass. I want to be confident in my pathology knowledge down the line. Right now, I feel none of that. Yes, I have worked hard – I’ve probably put in at least 300 hours to patho studying this semester – but I don’t think I’ve worked smart. I can’t tell you the number of days where I have only gotten one topic done – seriously, one topic in 9 hours of studying! I tend to make things too complicated and then completely miss out on the main point.

So, I’m calling it. I’m throwing in the towel. It feels like a failure, mainly because I usually push myself to the bitter end. Then again, maybe it’s not. Maybe this is the action that will push me to change. Maybe this will help me improve my efficiency and make me a better student. At least I hope it will.

The outcome tomorrow depends greatly on which topics I will get. I both want to pass and want to fail at the same time. The desire to pass comes from me wanting to escape this feeling, the pressure of patho. The desire to fail comes from me wanting to be  forced to learn the material properly and come back when I am truly ready for the challenge. And right now, I am just so, so exhausted.

Is this me growing? Only time will tell…

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.

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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!

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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.

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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):

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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!

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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

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My summary page…

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

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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:

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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).

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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!

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Midterms: Check!

March 29, 2015 § Leave a comment

This past week took me for all I had. For many it was a calm week before Easter break, but for me and several others, it was quite the opposite.

I started off the week already pretty exhausted since, last week, we had our midterms in medical imaging and pathophysiology. The medical imaging exam was significantly more challenging than we had been led to believe by students of previous years. We’d been told that no one would get anything below a 3. For us, it was quite the opposite: only 1 person got a 5 and 78 people got less than a 3! The class itself is divided into two parts, anatomy and biophysics, and this midterm covered the material for the anatomy portion. The exam consisted of identification of 80 anatomical structures in CT, MRI and gross anatomical images. Since this midterm was at 18:00 on the night before the pathophys midterm, the only studying I did was on that same day, for about six intense hours. Luckily, I ended up with a 3. I would have liked to do better, but I’d made the decision to prioritize pathophys.

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After the midterm was done, the last thing I was in the mood for was going home to do last minute cramming for pathophysiology. I battle quite frequently with anxiety before exams and one of the things Skjalg has suggested I do is to set smaller goals for myself. It’s so easy to say you’re going to “sit down and study patho” without actually specifying what you are going to cover. The problem with that is that you will never accomplish that goal. You’ll never be done studying a subject. The only way to feel like you are getting anywhere is to set smaller goals and actively feel proud when you accomplish those goals. So that night, after a little power nap, I asked myself what would make me feel proud, what would make me give myself a pat on the back and go to bed happy. I then stayed up as long as needed to make my goal, did a little extra and went to bed happy.

For this midterm, we had six topics for which we needed to know theory and diagnostics:

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The exam itself consisted of one case, for which we needed to evaluate, diagnose and plan treatment. We go through the cases during the semester, so there isn’t anything new at the exam, but you need to be able to do more than state a memorized diagnosis.

I was pretty nervous before the exam. I spent maybe half an hour walking around in circles memorizing the various values we need to know. When I finally entered the room, chose my topic and sat down to start preparing, I realized I didn’t recognize my topic at all. I had gone through it at least three or four times before, but it apparently didn’t stick. So, I had to go blind, with the knowledge that I had gained while studying and hope that the diagnosis I came up with was the correct one.

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Our examiner for this midterm was the same I’d had for my both my semi-final and the midterm last semester. He prefers you to walk him through your thought process, rather than immediately report the diagnosis. So, I took the time to read through the entire question with him while noting my inferences from the various symptoms and values. At one point I said that I suspected metabolic compensation due to the normalized pH value in spite of the low pCO2 and he asked the only question he asked me during the entire exam, “Is it?” (as in, “Is there metabolic compensation?”), to which I replied yes. At the end I stated the diagnosis – chronic respiratory alkalosis with metabolic compensation resulting from respiratory infection – and said that I would confirm it with a chest X-ray. His smiled and said, “Well…what to do with you…it’s a 5”.

Pushing through this week was tough. I decided to take my microbiology midterm covering fungi and parasitology this Thursday (it is scheduled for the 12th week, but he is letting us take it earlier if we want to) and then there was the matter of the surgery competition! The surgery competition took place on Friday, but before that, I had to pass the last mini-competition in our class on Thursday in order to be the one elected to go to the main one. We had a substitute teacher that day and were going to be practicing continuous sutures. I did ok during the practice and the substitute gave me good feedback, but when it came to our little group competition, everything went wrong…

To be continued 😉


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

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After: notebook

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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! 😉

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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!

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Ok, back to patho for me!

Post title: Quote by Tennessee Williams, The Glass Menagerie

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