Step 1

So, this happened today:

Yes. This is my registering for my board exams. I can't believe I am already getting to this point in my medical education....crazy.

For my non-medical student readers, the USMLE (United States Medical Licensing Exams) are broken up into 3 parts. The first part is taken after your second year of medical school and tests all of the basic-science knowledge. The second part is during your fourth year of medical school and the third part is during residency. So, I know I am only starting in my long string of licensing exams, but its still pretty crazy that I am already at the point of Step 1!

Besides registering for my Step 1, I also had a final exam today! So, far I have completed 4 classes; 1 ethics class and 3 blocks: Neurology, Infectious Disease, and Musculoskeletal. So, although I have not been blogging as much as I would like to... I sure have been a busy bee in all of my classes.

This year is going by RIDICULOUSLY fast.... I am officially more than 50% done with this semester. Only one more domain until Thanksgiving break (Hematology/Oncology) and one additional domain  (Psychiatry) until Christmas! :)

Planned Parenthood

Ok...let me start off by saying I tried realllllly hard to keep my political opinions off of this blog, but after last night's presidential debate and after a lunch-time talk I attended today, I decided I needed to get all of my thoughts out. So, here we go....

Today, I went to an optional talk offered by the Reproductive Health Elective at my school with a representative from Planned Parenthood. As I am sure all of you readers know, funding for Planned Parenthood is a current hot topic for this election, so I was very eager to attend and hear what the representative had to say. Mitt Romney has stated on many occasions that under his legislation, he will discontinue federal funding for "pro-abortion" non-profits, namely Planned Parenthood. So, if elected, one of his missions would be to shut down the thousands of Planned Parenthood clinics around the nation.

As someone who is pro-choice, a fervent believer in women's reproductive rights, and a future medical professional, I find it an absolute tragedy that this is even in discussion. For the last 10 years, since these issues of womens' health and reproductive rights have really been brought into light, women representatives have been silenced and denied opportunities to speak out about womens' health rights. Many of the legislatures that are making these decisions are conservative, white males with no medical expertise and no base understanding of what women's health involves. In fact, when Lisa Brown (a representative supporting continued financial support for Planned Parenthood) began discussing her views about an anti-abortion law and used language like "vagina" and "vasectomy"; she was immediately looked down upon and silenced.

A quote:

“I used that word because we were debating a women's health issue. Vagina, by the way, is the correct medical name of a part of women's anatomy lawmakers want to regulate. My statements were within the rules of the House and were clearly appropriate in relation to the bill we were discussing. One of my counterparts, Rep. Mike Callton, R-Nashville, said ‘vagina’ is such a disturbing word that he would never deign to use it in the presence of women or ‘mixed company.’ This, from a man who earned a bachelor's degree in biology.” -Lisa Brown

That was kind of a tangent...but lets get back to the main topic....

The support to discontinue funds for Planned Parenthood are founded on incorrect and incomplete information. The support is based on the idea of wanting to stop abortion rights by discontinuing organizations that provide these services. However, what many people with this view do not understand is 1) the wide range of services provided by Planned Parenthood, 2) the current policies on funding abortions, and 3) the larger societal implications that stopping this funding would create.

First, Planned Parenthood does not simply provide birth control and abortions; instead, there are three realms of services offered: medical, education and patient advocacy. So, along with basic medical care, PP also offers safe-sex education courses, parenting classes on how to discuss the birds and the bees, and advocacy for patients having the ability to obtain the health care that they deserve. In fact, 90% of what Planned Parenthood provide are preventative services. Only 3% of what they provide are abortion consults and procedures. Moreover, in Michigan there are only 2 centers in the entire state that offer the options of having abortions. Thus, the majority of centers are simply medical centers for women and men who cannot afford to see a physician (due to lack of health care...which is another different issue). So, for supporters of stopping federal funding to Planned Parenthood to say that this is stop abortion, it is clearly obvious that this lack of funding is missing the point.

Secondly, the current policies on funding for abortion is this: NO public fundings go to pay for abortions. NONE. This has been fact since 1976. So, again, this claim that stopping funding for Planned Parenthood would stop the funding of abortions is ludicrous, because these have not be funded for 35 years.

Thirdly, when you think of the larger implications if planned parenthood services are stopped, it is crazy to think of what will happen. Imagine what such a decrease in preventative medicine will do for reproductive health. Imagine if there is no funding for contraceptives, no options for women to get gynecological care and no education for teens about safe-sex practices.

This policy of defunding Planned Parenthood is a huge huge mistake that will have huge burdens on our future populations. It is easy for people who are pro-life to be swayed by the idea that stopping funding for Planned Parenthood will decrease the access to abortions, but it is critical for everyone to truly understand what this lack of funding will do and what larger implications may occur if this legislative action takes effect.

Summer Externship

I spent my last 4 weeks of the summer volunteering at the St. Johns Hospital & Medical Students, in a summer program for first year medical students. We each got to pick one specialty per week that we would like to work. Since I chose to do 4 weeks, I got 4 specialties. My first two picks were fairly easy, because they were the two specialities I was most interested in: Pediatrics and OB/GYN. The second two weeks I decided to try specialties that would allow me to see/do the most I could in a week. These selections ended up being Emergency Medicine and General Surgery.

Week 1: Pediatrics

I always knew that I would love the field of Pediatrics. Out of almost every field of medicine that I have shadowed, I always enjoyed working with the babies or young children more than any of the adult patients. So, needless to say, I was thrilled to be spending a week on Pediatrics. This week, I got to try out a whole bunch of different subspecialties. These subfields included: General pediatrics, In-patient pediatrics, Peds GI, Peds Nephrology, Peds Allergy/Imunology, Peds Hematology/Onccology and Neonatology. Overall, I had a really great week. However, I also had some moments of clarity on what I would want/wouldn't want in my future profession.

First, I want to say that I absolutely loved the patients! Kids are just so dang entertaining. However, I figured out that I don't really love working in the clinic all the time. Some days would be ok. but if my entire medical career was centered on clinic work, I think I would go nuts. In fact, my favorite days were working in critical care, especially in the NICU.

Positives: the patients and my love for children
Negatives: wayyyy too much clinic time.

Week 2: Emergency Medicine

After realizing I didn't love clinic during the first week, I was really excited to try out Emergency Medicine. The ER that I worked in is right on the border or Grosse Pointe (a very nice neighborhood) and Detroit (one of the poorest cities in America). So, I prepared myself to see quite a diverse amount of cases...and boy did I! The ER is sure not short on its excitement. From gun shot wounds, to Congestive Heart Failure, to car accident traumas, to foreign body obstructions (ex: kids sticking beads up their nose)....you truly don't know what you are going to get one minute from the next.

Positives: Excitement, diversity of cases, shift-work/no call
Negatives: Never really get to see a case to its end, very little time actually spent with the individual patients, and a lot of distrust in patients (because many people come to the ER for drug seeking)

Week 3: OB/GYN

This week, I got to spend 1/2 the time on OB and 1/2 the time on GYN. For OB, I spent some time in clinic doing prenatal visits and ultrasounds and some time in Labor and Delivery. For GYN, I spent some time in clinic doing gynecology visits and procedures and some time in the OR doing gynecology surgeries.

After this one week, I can say confidently that I LOVE OB/GYN. Seriously, what an awesome field of medicine! You get a perfect combination of clinic time (most attendings only did about 2 afternoons per week) and operating room time! I realized that I love the OR...both during C-sections and with Gyn surgeries. You get a great combination of procedural work and "medicine". You get a great mix of healthy and sick patients. You get a great fulfillment with bringing life into the world or with performing surgeries on women to alleviate suffering. It really is such an amazing field!

Positives: EVERYTHING! The mix of patients/OR/clinic/preventative medicine; many of your patients are coming in happy and leaving even happier, lots of interactions with other specialties (especially in the ER) and the excitement that comes with L&D and the OR.
Negatives: The crazy hours and crazy malpractice insurance...

Week 4: General Surgery

Going in to this rotation, I was kind of terrified. When I was told "you start at 5:45 AM", I thought this would be the hardest week of my life...even though I was really only following the residents around with no real responsibility. Yes, it was very busy, but I had a really really great experience. We spent about half of our time in the OR and half on the wards with Pre-op and Post-op patients. This week was really great for me as a medical student for a few reasons: I saw a crazy amount of diversity of cases and pretty much everyone there was very very sick. While I would never wish illness on anyone, as a student who needs to learn proper medicine, I was thankful for the opportunity to see all that I got to see.

Positives: Excitement of the OR (Yes, I clearly love the OR), lots of procedures, and lots of interactions with other specialties.
Negatives: Surgery residents are not always the happiest people, crazy hours.


So, going in to this externship I was pretty confident that I would be going into Peds. However, after this, I could honestly see myself going in to any of these 4 fields....but if I would have to pick this second, I think I would actually have to pick OB/GYN..I know I have a lot of time to decide, but for now...I will say that I am so so so excited for third year!