The Step


Published 3 years and some weeks ago, as I finalized my list of applications into the match for residency. Now, I get to interview prospective residents and walk them around. Deja vu much!

I stood on the edge, and felt terror rise in my chest. I took a deep breath, and forced it down, screwed up the courage for that one step and I took it. I stepped out of an airplane door, with instructors holding onto my shoulders and hips and jumped into space at 15,000 feet. I thought the hard part was over- how wrong I was.

Today, I’m a fourth year medical student. I’ve completed four years of college with a thesis in biochemistry and philosophy each. I’ve survived the two years of classroom learning of medical school and all of my core rotations. I’ve taken all the dreaded Step exams. I’ve spent 4 dedicated months in the Emergency Room, taken care of dying patients, saved lives and had people die under my hands. I’ve intubated people, put in chest tubes, and made decisions that could save or kill people. Why then do I feel that same terror rising in my chest now?

Perhaps it’s because I’m on another precipice. I’ve submitted 23 applications for residency and I have 15 interviews scheduled. I’m deciding where I want to be for the next 3 years of my life and I’m trying to pick a place that will make me an excellent clinician, researcher, possible academic physician, and writer. Not just that, the place has to work with my significant other’s job and our plans to move in together. And I have to choose the place that will let me do that.

I hold my future in my hands, and I’m rudderless in the competing currents of each possibility. Each place gives me compelling reasons to come there, shows me visions of who I may become through them, and touts the successes of those who were in my shoes just 3 short years ago. The magnitude of this decision and its effects on my life and my future are dizzying and terrifying. Though I have a gut feeling that I will make my own luck and my own future at whichever place I end up.

As I fell from 15,000 feet with my instructors on either side I felt sheer terror. I fell at 120 miles an hour, screaming towards the earth. Fifty of the longest seconds later, and my parachute had opened somehow. My terror abated, I began to breathe again as my trembling hands reached for the cords and attempted to steer me towards where I needed to get on the ground.

Perhaps then this rising terror is from who I’ll be when the parachute opens. For as I step into the abyss I am a medical student- now bereft of responsibility and blame. A few short years later when the parachute opens I will be an attending physician sailing on my own steam. I’m stepping into the abyss in a few short months- I suppose my choice, as I step, decides who my wingmen (and women) will be when I’m free-falling with the terror rising in my throat.

Geronimo!

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Exceptional


Continuing the theme of posts I’ve written in years past, this one talks about the weirdness of having a self admitted mediocre student being called exceptional. I remain, quite honestly, mediocre at many things, but somehow clinical medicine clicked with me, and allowed me to become better than mediocre. 

This post was written halfway through medical school! Enjoy!

 

It’s a lovely word, exceptional. Makes you feel all warm and fuzzy inside, gives you this idea that you’re something more, something above and beyond, raising your self image to dizzying heights.

 

It’s something I’d never heard till I got to college. Through my middle school, my report cards would read, “Can do so much better if he’d apply himself” or “Capable of so much more.” In college, I started hearing the word smart, or even gifted applied to my name. I convinced myself that I was actually just gifted, and the fact that I’d done two years of college level Biology, Physics, General and Organic Chemistry in high school had little to do with the apparent ease with which I achieved academic success. So, I coasted through college on autopilot, passed out in nearly every class with my legs sprawled out on the seat ahead of me, working through experiments, projects and exams in fractions of the time of the rest of my class, never seeing the frustration on their faces as I did these tough tasks with obvious ease. I tried to explain that I’d done it before, but I didn’t try very hard. I enjyoed the mystique the achievements gave me, enjoyed the feeling of being seen as gifted and smart, and I loved hearing from the people around me, professors, peers, and the people I taught that I was exceptional- sometimes in words, or sometimes in just the way I thought they saw me. So, I remained oblivous to the trial and the tribulation that is hard labor of the mental kind. I graduated mangna cum laude, with college and departmental honors and sundry pats on the back from the world.

 

I then moved onto medical school convinced in my little mind that it’d be the same thing as college, that I’d be able to sleep through my classes and still outshine everyone else. The first day of medical school, as they explained that we’d be dissecting on one day and studying the other, my small group was told we had a study day first. So, I floated around the library in this vast new building unsure of what the heck to do with myself. I opened my Netters, and promptly passed out with my face in it, drool leaking from my open softly snoring mouth onto those glossy perfectly drawn images of the anatomy we were to learn. The next day, during cross teach, when the other half of our group who had dissected taught us, I experienced what it’s like to feel like an idiot for the first time in my life. There were terms flying around I’d never heard of, gray structures that looked identical to my naive eye being distinguished from one another all the while I tried desperately not to throw up my breakfast. I was like a fish lost in the desert, totally out of my element. Slowly, I got the hang of it, but that first two months I learnt to feel like a fool and began to downgrade my estimate of my own intelligence. I still didn’t study, since I’d never learnt how to; hoping instead that somehow magically I’d survive. I did survive anatomy, and felt much more comfortable during Biochemistry (since that was my major in college) but my self esteem was about the lowest it’s ever been in the first two years of medical school. I’d gone from an honors student in college to an average or slightly above average medical student. The swagger and arrogance of my college years remained as a thin veneer to hide the fear and insufficiency I felt on most days, with my peers the equivalent of linebackers to my metaphorical ninety pound weakling being kicked in the face with the sand of anatomy, phyisiolgy and pathology. The sense of meaning, purpose and power I’d felt in college, the heady sense of strenght, and the knowledege of where my path was leading was replaced by a never ending gnawing self doubt that nibbled at the foundations of all of my choices, questioning why I came to medical school, what it was that I hoped to accomplish and fear that the Siphysian task of learning all this material would never end.  Nearly every day I experienced at least moments of dread, fear and anxiety, feelings that I wasn’t cut out for medicine, that I was in the wrong field. I’d heard that it would get better, but the future was so far off, with such daunting obstacles between me and it that there were days I nearly despiared of my goals.

 

Somehow, I managed. I passed my Boards, and did fairly well. I began my rotations, jumping into psychiatry where I had always done well in my boards and my classes. I found my strengths again, talking to people- a skill that had nearly atrophied in my two years of social isolation, finessing out the details of their conditions and trying to match their symptoms with this whole set of diseases I’d had stuffed into my brain over the last two years. I guess some of it stuck, because I was doing quite well by the end. The soft skills I had discounted in favor of my so called intelligence in college, of conversation skills, charm, courtesy, politeness, and reading people began to show their worth as I searched to find them under the haze of biochemistry formulae and physiology concepts. So, I started hearing the voices again (not the schizophrenic kind), those of my attending physicians and my residents, telling me that I had skills, that I could be of value in medicine and I could be a good doctor. I spoke to a resident yesterday, a self described hard ass who ‘didn’t kiss medical student’s asses’ who said the magic word to me- exceptional. She called me an exceptional medical student, not so much for my fund of knowledge, but for my abilities with people, for the confidence to ask questions and try things, and most importantly the confidence to give it a shot and be totally wrong- something I have in abundance.

 

“Becoming a Doctor”


I’m about to graduate residency in Emergency Medicine, and as I think back, I realize that I forgot completely about showing my blog and website some love. So, here we go- in memory of all the insanity that’s developed- a walk down memory lane. I’ll try to update and post frequently!
“Write your name on the paper,” he said. Since he was a senior who’d just gotten into medical school, and I was a simple sophomore who’d chosen to attend the session, I did. “Now write Dr. in front of it.” I complied. “If you’re reading that and you don’t feel anything, medicine isn’t for you,” he said. I looked at it again, my name with a Dr. in front of it. I didn’t feel a thing. I crumpled up the paper, chucked it in the trash and didn’t give it another thought. Until today that is.

In four days, I’ll get to write a Dr. in front of my name. More than that I get to call myself a doctor is the fact that I get to be one. In a few weeks when I start residency, I’ll be responsible for people’s lives. And that is terrifying!

It’s been a long journey, since my careless sophomore days. I went from being a cocky, know it all college student, patted on the head for my intellectual acumen to a terrified, foppish first year medical student who spent my first year lost and confused. I was petrified in anatomy, as I was constantly less aware than my classmates who with reckless abandon pointed out the vagus nerve, the mesenteric arteries and dismissed much of the fascia I believed was important anatomy. I drowned in the weight of neurophysiology, as I discovered that the brain was and remains a complete mystery to me. I threw up, in the hotel before I went in to take my Step 1 exam and was mortified when I barely made an average score. I spent my first years of medical school battling the terror of inadequacy, afraid I wasn’t good enough or capable enough.

But, in four days, I’ll be a doctor.

I was terrified that I was playing doctor this entire time. Mortified that my medical school experience was not enough, that I was unprepared for the next step. Then, I realized something.

I’ve diagnosed and initiated the management for dozens of diseases. I’ve read hundreds of EKGs and chest X Rays. I’ve brought life into this world with my own hands, and been there when it’s left. I’ve fought violently against death, breaking ribs as I tried to bring back a patient from the precipice. I’ve watched death softly take someone who was ready to go. I’ve cried for a patient, in the arms of my lover, after I first told someone they were going to die. I’ve violated the sanctum of the body with chest tubes and central lines in hope that someone would live.

My family, like families tend to, have introduced me as a doctor for a few months now. I’ve demurred, each time saying “I’m not a doctor yet.” Like my white coat ceremony I need something to mark the movement from a medical student to a physician and to mark the importance of the situation. I realize, however I’m not there yet. Though I’m getting my degree I have in Robert Frost’s words, miles to go before I sleep. And I’ll never be there. I’ll constantly be learning, making mistakes and fixing them, and forever humbled by the vast enterprise of medicine I’ve had the audacity to try to conquer.

I’ve been becoming a doctor for a long time now. The MD I get to put at the end of my name has been in the works for eight long, caffeine fueled, sleep deprived years. I’m going to spend the rest of my life living up to the promise it holds though- because that’s what becoming a doctor really means.

Playing Doctor


The words by now flow off my tongue. “I’m Sarab, the fourth year medical student” comes off in a rhythmic flow without a second thought. My position is comfortable, even simple. I am expected to be there, participate to some degree and occasionally know the right answer- I am after all, a medical student. So, I zone out during rounds, disappear for hours at a time and do my own thing- it’s not like anyone is depending on me. Gotta love play time.

I’ve been playing doctor for quite awhile. The thrill of wearing a white coat has subsided as the white coat has become progressively less white. I’ve been seeing patients, examining them, making plans and presenting for almost two years now and it’s all second nature. I look, think, plan and suggest. Other people watch over it and agree. The scary part is that in 70 days I’ll graduate medical school, and I won’t be able to play at being a doctor anymore. In 126 days, I’ll be a resident in Emergency Medicine.

The complacency and comfort of my current position only adds fear to the change that is to come. In a few short months, I’ll be putting an MD after my name. In a few short months, I won’t be the ignorant medical student- I’ll be the ignorant physician.

My future (hopefully) program chair said it best- the only person who should call you doctor after you graduate medical school is your mother. You learn the basics of medicine in medical school. You learn to practice it in residency. For the first few months of your residency, you’re watched like a hawk as like a newborn foal you start to find your feet, wobbling and falling a few times. You’re watched for your safety and your sanity- the sudden onslaught of responsibility and consequence to your actions can be terrifying. More importantly, you’re watched for the safety of your patients. I’ve been told that until your second year of an EM residency, you’re not really a doctor. I guess my playing days aren’t done yet.

The Evolution of a Medical Student


At this moment, I’m on the top of medical student evolutionary tree. I’m a fourth year, strutting my stuff in the hospital and casually describing intubating, sticking and poking people. A few days ago, I got to run a book discussion for the new first year medical students.

As I walked into the medical school I walked down memory lane a little. I relived the boring hours of my first years orientation and how little it oriented me to medical school. I relived the shock of my first day of anatomy, and how I was told to “go read” since my group didn’t dissect that day- but I had no idea what to read… I remember how I felt, going from a cocky, confident, relaxed college student who was big fish in his little pond to a medical student who was surrounded by people who were smarter and studied harder. I remember the feelings of inadequacy when I didn’t get an honors grade on an exam, or it seemed that my peers were so much more clued into a concept than I. I remembered feeling like I didn’t belong- that somehow I’d crept into medical school and would be discovered and laughed out.

I recalled how magically in my third year of medical school, when I was seeing actual patients my strengths came out. I could talk to people, get a good history, make a solid differential and decide how to work them up. I could explain in non-medicalese why I thought they needed something and work with them when they didn’t want it. I remember beginning to enjoy going to the hospital, feeling like I was where I could do good work, where my actions and my words meant something. I remember the first time I was called “Doctor” in the hospital and how I meekly responded, I’m just a medical student.

I remembered how in my recent Emergency Medicine rotations, I was being given great autonomy and freedom. I could confidently walk into a room of someone who was sick and make decisions to make them better. I had acquired the skills to take care of people- diagnosis, treatment and decision making. I remembered most recently when I was leaving the room of a woman who had come in with abdominal pain how she had said in parting to me, “Thank you doctor” and I had smiled in return as I walked out not correcting her.

If you told my first year self that I was going to be who I am now in a few short years I’d have reacted in disbelief. At this moment I can scarcely believe that I was once that timid, that new or that scared.

I told the new first years some of this. I doubt they believed me. But maybe in a few years when they’re looking back at their beginnings they will.

Oh, and in terms of advice for you first years, here it is. Watch “Dead Poets Society”. Then you go and carpe the hell out of that diem.

Emergency Medicine from the eyes of a novice

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Having a week of my Emergency Medicine experience under my belt, I’m sure I totally qualify as a veteran.

With my novice eyes-here are some observations and thoughts.

1. ER Docs aren’t your family docs or internists: Just yesterday I saw a lady with a slightly elevated blood pressure who’d been sent in by her visiting nurse because she hadn’t taken her medicine and needed a checkup. Talking to the patient revealed that she needed to follow up with her PCP who she’d not been able to see in a few months, and the nurse had figured that the ER would do that for her. The thing is the ER is a place for emergency care. If you’re having a heart attack, a stroke, delivering your baby, got hit by a baseball bat you need the ER. If you need a checkup and the wait times are too long at your PCP then the ER isn’t the best place for you. Between the traumas, the people with heart attacks and strokes and all the rest you’re not going to get the care you need.

2. Emergency Medicine is based on treating or ruling out emergencies: If you’re entering your EM rotation your attending wants two things from you on the differential- the bad things that could kill you and what it probably is. They’re far more worried about your chest pain being a heart attack and ruling it out before they send you home, consequently what could likely be something benign like a strained muscle can be treated once we’re sure it’s not a heart attack.

3. Not every patient in the ED will have (or needs) a diagnosis: As gratifying as most physicians find it to get an answer they can hang their hats on, the ER is often not the place for it. You’d like to, in an ideal world, figure out what’s going on with a patient but realistically when there’s a 3.5 hour waiting and 40 patients outside in the waiting room with a couple of traumas rolling in and the guy in bed 4 actively seizing you prioritize. That ends up leaving some of the things that need to be worked up on an outpatient basis as just that- waiting to be worked up outpatient. The ER is an incredibly expensive place to receive medical care as is the hospital in general so ED physicians try to judiciously use resources.

4. Sometimes people will hate you: The ER is a busy place, and there are always people you’ll be admitting. Often when you’re admitting someone to a service the resident on staff may be flabbergasted that your history and details didn’t include a more detailed family, social or physical exam- and that’s fair from their perspective. The problem comes, from an ED perspective a lot of those questions and answers won’t change an initial management. Secondly, anyone who’s causing your already busy workload to increase is likely not going to be your favorite person. For that reason, you may have the odd consultant who doesn’t jump for joy each time you call. That’s okay though. As long as the patient ends up being cared for.

5. Emergency Medicine is heavily weighted towards management:  Something I learned the hard way in a simulation session is that EM is a heavy management specialty. The traditional paradigm is for one to get a history, do a physician, collect an assessment and make a plan. In EM- you start with a plan then you keep going. And you modify your plan as you go. It seems rather obvious but if someone is coming in with chest pain that could be a heart attack you don’t want to spend 30 minutes getting a history and physical while the guy is actively losing heart muscle. Obvious it may be- it’s often challenging to make the switch from sitting and talking before you’re touching the patient and doing things to them. That said- 1 week in I’m already beginning to talk to, examine and treat my patients simultaneously.

 

In case you were curious I’m going to go into EM. Aka:

12 medical specialty stereotypes

 

 

 

 

 

 

 

 

 

A Labor of Love

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I stood in the room, gowned and gloved, waiting for the woman to push. There was a thin trickle of sweat running down my back where the bright lights of the delivery room were trained. The baby was just short of the pubic bone, nearly ready to be born.

The mother-to-be had been pushing for hours and was exhausted. We watched the strips that recorded her and her baby’s heartbeats—each time that she pushed, her heart rate spiked to more than 170 beats/min and she closed her eyes and blew the air out of her lungs as we urged her on. “Push. Push. Push.” “Breathe. Breathe. Breathe.” We continued, our implacable rhythm timed to the clockwork contractions of her uterus.

Her exhaustion had caught up with her; I could read the defeat in her eyes as she whispered to her husband, “I can’t do it.” He smiled into her eyes and whispered back quietly, “Yes, you can.” My eyes were transfixed by this private moment between husband and wife, for all intents and purposes alone in a crowded delivery room, oblivious to the five other people standing around.

My hands moved on autopilot, assessing the baby’s position, a job my eyes should have done, as well. I stood there, doing what I was supposed to by habit—this was the fourth delivery that I’d done, after all, and I was a 5-week OB veteran. I stood there watching this moment, this beautiful, private moment, and some of life’s mysteries became clearer.

It was suddenly apparent to me how much I’d given up to be the one bringing this couple’s baby into the world. The fact that I could be welcomed into this intensely intimate moment and thanked after I’d done my job attested to the value of the profession I was joining. But in this moment, I wondered, at what cost?

This couple was a few years older than I. They had been married since they were my age and were having their first child now. They were madly in love, had jobs that fulfilled them, and were bringing their first child into the world.

At that moment, I had one purpose, one raison d’être, one thing I was searching for—that obsession, that passion, was medicine. In pursuit of it, I’d given up my hours, my sleep, my financial future, my social life, and my relationships.

My family was thousands of miles away, rarely seen and always missed. My friends were languishing, with unreturned phone calls and text messages on my phone, forgotten among 14-hour shifts and minutiae that needed to be memorized for each rotation. My love life was challenged by my constant lack of time and impossibly high standards—not to mention my jealous, unforgiving mistress named medicine.

She pushed again, and I snapped back to the here and now. Her son was crowning, and my hands moved automatically. I checked for a cord around his neck, pulling him out of his mother’s womb, one arm at a time. He was born from a warm and safe womb into the cold and lonely world he would now inhabit.

I swaddled him in blankets and placed him on his mother’s chest as his parents stared at him with love, drinking in the sight of his fingers, his toes, his perfect little features. I finished my work quietly. They thanked me warmly as I left the room and ripped off my gown and gloves as I went, their eyes never having left their beautiful baby boy.

I smiled as I left their delivery room, lost in my bittersweet thoughts. I kept walking because my shift had been done 20 minutes ago. I walked to a house filled with books about medicine and the tools necessary for its practice—stethoscope and white coat among them. I walked to an empty house and an empty bed. I was on again in 9 hours.

Ann Intern Med. 2014;160(9):653. doi:10.7326/M13-2673

The Things They Carried: An MS3 Story

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Having just finished my third year here are the things that made my life easier.

1. Comfy shoes: Try walking around the hospital on rounds for >4 hours a day and standing in one place in a pair of uncomfortable dress shoes. I dare you. I can’t even imagine how it would be in heels. Buy yourself some comfy shoes for work. I use rockports when I need to be dressed nice and a good pair of sneakers for when I’m in scrubs. Invest in them- your feet will thank you.

2. UpToDate Mobile: You can signup for an uptodate username and password at any hospital computer and download the mobile app. If you’re not familiar with uptodate it’s the best way to quickly educate yourself about relatively recent guidelines, pathophys, treatment etc. Keep it on your cellphone so you can read whenever you get a second.

3. A stethoscope belt: Stethoscopes can be heavy. Wrapped around my neck it started making me stick my neck out like a turkey. Around Thanksgiving that’s a dangerous thing to look like. A stethoscope holder may not be the most fashionable thing around, but a few days in the hospital will make a sartorial slob out of any fashionista.

4. Snacks: Keep your white coat well stocked with snacks. You may prevent a hypoglycemic coma on Surgery, OB-GYN, and Medicine.

5. A gym membership: You need to stay sane in MS3- it’s busy and you’re going to need things out of medical school you can focus on. For me that was the gym. It was my endorphin rush, my cleanser and my calmer. Do what makes you happy dude.

6. Books: Walk around with the books you might need on your rotation. They’re specific so expect a post to follow later, but a good one year round especially around Step 2 time is USMLE Step 2 Secrets.

7. Reference Guides: Everyone suggests you buy the “Green Book” (used to be Red, now is purple). It’s the Pocket Medicine series and was questionably useful on medicine. Buy it if you’re really keen.

8. A credit card in your ID holder: Your stomach will thank you when you’re in the cafeteria with 10 minutes to eat between OR cases.

9. Pens: Black for the hospital- no blue. And keep your nicer pens on the inside. An attending or resident can snag a pen and “forget” to return it…

10. Fresh socks/Undies/Toothbrush: This one should be self explanatory- but post call- these are amazing.

11. Gum: If like me you’re prone to the sleepies especially after 4-5 back to back OR cases while sitting through a fascinating lecture on the biochemistry of transplant rejection- have gum in your pocket. Or your attending WILL make fun of you.

12. Someone to complain to: We complain. That’s what we do. We complain about our lives, the slights both real and imagined that we endure and the futility of our positions. You need someone to complain to- or lots of someones. So keep friends, significant others, classmates, parents, everyone handy. You’ll need them.

This will be one of the best and worst moments of your lives. My two months on IM was the most educational experience in all of medical school. The year will transform you from a bumbling and eager to please second year into a slightly jaded, somewhat educated, rather arrogant semi-physician.

In fact I’d postulate that the bulk of your learning pre-residency happens in this year. Buckle up. It’s going to be a fun (if slightly bumpy ride!)

 

Third Year: A Survival Guide: In memes

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Third year of medical school is a different beast from anything you’ve had before. You’re going from studying the basic sciences in a laboratory to functioning as a part of a healthcare team. You’re expected to truly learn to begin to be a doctor- and by the end of it you’ll be expected to manage patients to some degree autonomously. It’s a lot of work, a lot of fun, a lot of misery and just a lot- all at once. So with that in mind here is what to expect- #whatshouldwecallmedschool style.

Third Year

(http://whatshouldwecallmedschool.tumblr.com/post/80871300029/medical-school-in-a-nutshell)

This is going to be you much of third year- sprinting around the place, going nuts and basically losing your mind. Live with it and own it.

That said, the biggest thing that worked for me in third year was confidence and trying to get comfortable. Some people and some places have this idea that medical students just sort of stand around like part of the furniture. And there are those who do that!

I’ve found that the people you work with and work for- attendings, residents, interns, nurses and above all the patients appreciate you trying to do things. So when you’re asked a question, answer it with confidence (not a question). Surgeons especially hate that. If you’re not sure, start talking about what you think is going on- typically someone will cut you off if you’re rambling. But if you see someone starting to fall over asleep you should probably stop.

Don’t be afraid to get your hands dirty and do things. In my third year, I’ve delivered babies, opened incisions, stapled heads, done ABGs and placed more Foleys than I would ever want to. The reason I got to do those while some of my colleagues didn’t is that I asked if I could!

Even when you’re on a rotation you’d NEVER ever want to go into- try to learn something.

On a psych interview

What I tried to do (most rotations) was pick one thing or one skill set I’d like to learn that I found interesting, was cool, or could help in me in my future field of choice. And then go out and try to get good at it.

So on OB, I learnt to deliver babies, and do cervical exams. The only way I got to do those is by letting my residents know that I wanted to learn and do those things, and them being nice enough to let me. But still- try!

 

Also, some residents may in general be not the most interested in teaching- that’s the luck of the draw. And that’s okay.

 

 

 

The other thing is prepare to do a good impression of a piece of furniture in some situations.

“This is my medical student”

My favorite is when you’re rounding on a team of 10 people, you all squeeze into a patient’s room and then you’re introduced in an offhand fashion as you have to half sit on the patient’s grandmothers lap.

Though seriously, people don’t really hate medical students. They know we’re learning, that in a year or two, or three we’ll have an MD or a DO after our names and need to take care of them. And most are okay with us learning on them.

It helps if you are comfortable, a little charming, and not totally creepy- a high bar I know.

It’s okay being the wall, but if you’re comfortable introducing yourself do so.

And with that we’re back to confidence. If you want third year to go well, be confident. If you’re not, fake it- till you feel confident and comfortable. The hospital is an alien environment for everyone initially, but if you want to be seen as a better medical student (and one of the most important things for anyone evaluating you is how you interact with those around you)- for two med students with the same thoughts, grades and physical appearances- confidence can make one seem a far better physician to be than the other.

 

As I round off the remainder of my surgery rotation and consequently the last rotation of third year, expect some more gems like the ones above. And if you’re interested in medicine/ in med school/reminiscing about the torture that is med school dive into #whatshouldwecallmedschool. I’ll leave you with a link to one of my favorites.

http://whatshouldwecallmedschool.tumblr.com/post/81984496130/welcome-to-third-year