Wish Me Luck

Good Evening from Calgary. This is just a very brief post to request your good vibes and happy thoughts tomorrow. Why you might ask? Well, tomorrow is my first certifying examination for which I feel quite under prepared. That begs the question of why I'm creating a blog posting instead of studying. At this point I'm wondering if perhaps good luck thoughts from around the globe might be more productive than further review of a multitude of acronyms. Probably not but that is what I'm telling you.

To give you a taste of the things I'm trying to keep sorted I'll give you a small list. However, I'll start with one key acronym - MPL. This refers to the minimum pass level. This is the mark (which will be determined after the test but is usually around 65%) that you have to achieve to be considered competent and not have to resit the examination next summer. So of all the acronmyms I care about at this point in time the MPL is the most important one.

Some other acronyms of note include: TTP, HUS, CML, CLL, ALL, AML, DIC, Plt, Hb, DDAVP, ET, PRV, PCR, HBA, HBV, HBC, antiHBs, HBsAg, IgG, IgM, IgE, HEELP, ALP, ALT, AST, MFD, MFS, DVT, PE, ALF, PJP, NHS, EtOH, MAHA, AIHA, CMV, HSV, HZ, HIV, RBC, WBC, A1AT, PK, G6PD, TPN, TPA, TIPS, ITP, and the list goes on.

However, I'd best continue studying. Tomorrow I write the first part of the exam (1pm-4pm MDT, worth 80%). Then on Friday from 12:30-1:50 I write the second part which is based in the lab and on identification of blood smears, pathological specimens, and anatomy based on cadavers which is worth 20%. With that I will wrap up the first course of medical school and be ready to move on to our next course which is the Musculoskeletal System and Skin.

A Break In the Silence

My apologies for the long silence. I've begun to get a few questions regarding the status of my blog and if you haven't found anything it is simply a reflection of my lack of writing as opposed to any technical difficulties that I am aware of. In my last blog I reflected on our first formative exam (which didn't count for anything). I got my results back and was pleasantly surprised with an overall satisfactory performance, even on the peripatetic component of the exam. There were some identified weaknesses but overall I was pleased. I have some room for improvement but that is the way with any assessment.

Medical school has settled into a routine which has reduced my number of 'exciting events' to tell you about. This is not to say that there are no longer exciting events but the novelty has worn off a little bit. For example two weeks ago we spent a whole week on diarrhoea. While this may not be particularly appetizing to many people I found it quite amusing and interesting. There are a number of causes, types, treatments, etc so I now know much more about diarrhoea than I used to.

Our first course is in its final stages. We have 8 more days of new material, a week of review, and then we write our summative exams (counting for 100% of Course 1) on October 22 and 23 which is coming right up. Thus, I have a lot of review to do in the next couple of weeks. By some rough figuring we have had 220 hours of lecture in this course with approximately 9000 powerpoint slides to review. While some of them are empty, introductions, charts, not important, there are still a lot of slides to click through...but I'll get through it and pass if all goes well because I certainly don't want to have to rewrite next summer.

We are almost finished our clinical correlation for this course. It has been interesting to see our skills improving. In terms of taking a history and performing a focused physical exam the difference between our first sessions in late August and now the difference is night and day. We still have a long way to go but we are definitely gaining skills and we have learned a lot. We will never be able to learn it all but the increase is phenomenal. During history of medicine last week one statistic that came up was 'medical students learn on average 20 000 new words in their first 2 years of medical school'. I'm not certain that it is actually this many words but at any rate we are learning a massive amount of information about a large variety of topics.

We've learned about a lot of different things but by far the most enjoyable part of medical school remains our small group and patient interaction learning situations. This past week we got to observe two gastroscopys - one showed a normal esophagus and duodenum while the other showed a Mallory-Weiss Tear (a tear resulting from retching at the gastric esophogeal junction). The Gastroenterologist put several little metal clips into the tear to hold it together and stop it from bleeding and that was that. Later we met a patient and practiced taking a history from him (as a small group of 5) and then I performed the abdominal exam - there were no visible scars, stigmata of liver disease, there was no bruising or significant superficial veins. There was mild edema in the ankles but no bulging flanks. Bowel sounds were heard on auscultation, there was no tenderness on light or deep palpation, Castel's Point was negative for splenomegaly and there was a palpable spleen edge just below the costal margin...so we are getting there.