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Things are getting just a little bit crazy in the last couple of weeks. First of all we have a big Pharm test coming up on Monday. This is the only class in the first two years of med school that likes to give comprehensive exams throughout the course of the year. This will be our third exam but will cover all the material we have had so far. This class is quickly becoming my M2 year Waterloo, much like Anatomy was last year. I just cannot seem to get into it. I haven’t found a good way to study and it the information seems so unorganized to me. I tried note cards for the last test, but it took me forever to make them and then I really didn’t have time to go back and study them. This time I’m building summary sheets in Excel for each class of drugs and will hopefully reduce my study material to 20 pages or so of concise information. But I’m not through with that yet either and I’m running out of time.

Also last week my lab partner of two years had to withdraw from school on a medical leave to try and get her health back in order. Not only has she been my lab partner for every class we have had, but she was also my partner for our ICM preceptor. I have to go that alone now also. I hate to sound selfish about it though. I know it is an extremely tough thing for her to have to sit out a year after working so hard to get to this point. I just hope she is able to bounce back. I had to do my first solo history and physical yesterday. My preceptor, an internal medicine doc, set me up with a list of patients in the hospital. I took down about five names and with white coat on, and my stethoscope around my neck I headed for the wards. I have to admit that I wasn’t really excited about doing it. Not that I was unconfident, but I needed to be studying Pharm and it seemed like an intrusion on my time this week. As I tromped down the second floor wing that my patients were on, I tried to tell myself that this is what I would be doing a LOT of for the next 2 and a half years so I better get a little enthusiastic about it. I found the first room on my list and knocked softly on the door, as I pushed it in wide enough to take a look. There was a large man moaning softly, with the lights out and no TV on. He looked to be only half conscious. I quickly decided that he would probably not make a good first H&P subject and quickly shut the door. It was a good call too, because the next guy on my list turned out to be a real easy guy to talk to. He is currently incarcerated at the MS state penitentiary and had a armed guard in the room with him. He had been told to expect me and was ready and eager to help out someone in the “free world” as he called it. I sat down on the bed with him and in the course of a good 45-minute chat, felt like I got most of the information I needed. I had lost the little white laminated cheat sheet our ICM director had made for us that covered all of the elements of a good history. I had reviewed them in our book (Bates’ Guide to Physical Examination and History Taking) before going and had made myself a little template. This guy was just so glad to have someone show an interest in him that he told me everything I wanted to know. The physical consisted only of a cardiac and pulmonary exam, as these are the areas we have covered in class so far. I left his room feeling satisfied and confident. It was easy to get a rapport going and I was nice and relaxed. I even got a little bit of an ego trip going when the security guard repeatedly addressed me as “Doc.” At one point a nurse came in the room and when she saw me, she said she would come back when I was through. It all made me feel like I was supposed to be there and was doing a good job. I have to write up my H&P tonight and get it to my preceptor tomorrow. He will meet with me Friday to give me some feedback. As I write it up, I may find some things I missed and can go back by to see my patient tomorrow. I may just stop by and see him anyway. A very cool thing about the preceptor I was matched with: no ties! Our course director said that we should take care to follow the lead of our doctor in deciding how to dress. When I saw my guy favored the open collar button down look, I was pumped up. No stupid neckwear for this preceptee!

The other time killer this week is microbiology lab. They are teaching us to be bacteriologists. After a couple of labs learning to do gram stains, and isolating cultures, we have to identify unknown species this week. Each student got a broth with two specimens mixed together that we have to culture, isolate and identify. We have a little flow chart algorithm and we’ve got to successfully identify at least one of the species to satisfactorily complete the lab. It takes several afternoons to complete, as you have to incubate cultures overnight a couple of times. I have my bacteria isolated and have each species narrowed down to two choices. Some tests tomorrow will hopefully complete my work. I find it pretty interesting, but again, I’m way behind on Pharm and every minute doing something else feels like a waste of time

After the exam on Monday though, things will be great for three whole weeks. We will finish out the week and then get our Christmas break and no more exams until January 10th! It will definitely be a relaxing Christmas!