Monday, October 26, 2009

Q and A

Holy crap I got a question!

First off, it is very nice for the few of you who actually view AND read the diatribes to comment on them. I am very happy knowing I am not the only one who reads this pablum.

A fellow second year at PCOM (would of been your classmate) asked:

I was just wondering what specialties you are considering? Are you going to take the COMLEX and USMLE step 1? Have you studied for them yet?

First off, I am considering Emergency medicine with a fellowship in Sports Medicine as my specialty. Truth be told, I have no idea since I haven't been through third year yet. I shadowed a EM D.O. and he had some of the funniest stories I have heard for quite some time. The sense of humor and mellow moods of the ER attending's and residents reflect a choice of profession which I could really, really enjoy. I also read every now and then and he has some gold written over there on his site. I like sports medicine because I am a jock and a hockey guy and I would love to be a team doctor when I am 50 or so. Although during our current system (cardio/resp) we were introduced to an interventional cardiologist. That guy is the man. First off, he is laid back and not overbearing when he teaches (an instant plus in my book). His license plate reads "HRTFXR" and he drives and Aston Martin DB-9. Yes, yes we all wrote on our personal statements how we want to be doctors to "help our fellow man" but DAMN!

He's got my dream car!!!
So that specialty has recently gained ground in my eyes.

As for the boards, I came into first year set on taking both. As of right now I am unsure as whether or not I will. I can't seem to take my own advice. I have yet to crack open First Aid while some of my classmates cling to their copy like folk from Kentucky cling to their bibles. If I had actually executed properly and done the first aid route I may be in a different position. So as of 10/26/09 at 1742, I have no idea what test I will be taking.

I will however start studying for the boards in December. I will probably utilize either Kaplan Qbank or USMLE world Qbank. Taking 1 hour a day wouldn't be so hard I suppose. I am not sure how your school does it, but NYCOM schedules our end of the year at the end of April, then administration brings in Kaplan to teach for about 5-6 weeks up through the first part of June. then we can take the exam. I probably will not go this route as to me that seems like cramming for the boards and that simply won't do. I am looking at kaplan classes that start in January/February so I can start just a tad bit earlier.

Get back to me young Student Doctor and tell me what your plans are, and I will offer updates on what ultimately I plan on doing. Thanks for your interest and question!

See you in new orleans! (if you are going)

Whoop Whoop


XBOX is to Cardiology as _____ is to Respiratory

Remember your SAT's? I sure do. I remember how that test was going to set the course for my future and collegiate options. Then came the first organic chemistry test. the test which was to decide if you could actually master the biological sciences (beside $&@#!#@% genetics) and see if medical school was actually a viable option while all the English majors smoked pot and watched reruns of full house. Then there was the MCAT, the mother of all graduate exams which would either fulfill your hopes and dreams or simply crush your soul.

Certain tests have milestones attached to them. For me, our last cardio/resp test is not one of these.

Cardiology is super fun. Beside learning the basics taught to you since high school (The pulmonary artery carries what type of blood?) you eventually marvel at how complex the organ the size of your fist works and inevitably confuses the bejesus out of you come test day. The heart is very, very complex and very fun to learn about. By far the best topic covered are EKG's and more importantly deciphering them. Although I read the book conveniently titled All you'll need to Know about EKG's, I'm pretty sure those rhythm strips were made by a child who's drawing with a crayon at Friendly's. Its amazing after a few hours of study how much information can be elucidated from that one piece of paper. Everything from heart rate to regular/irregular rhythms, to supraventricular arrhythmia's to myocardial infarction can now be diagnosed quickly within a minute. Although learning the basics of EKG's seems trivial now, i do take solace in the fact that I doubt House has any idea what those squiggly lines mean. Pathology of the heart is also quite interesting. Sure you cover atherosclerosis to the deal but valvular pathology is cool when you extrapolate the pathophysiology and combine with it your physical exam skills, you really, and I mean REALLY, know why the heart murmur sounds like it does and what exactly is causing the murmur to occur.

I suppose the only downside to cardio is the pharmacology. The heart is incredibly important which makes it a cash cow for drug companies. Therefore there are multitudes of drugs with only minor differences, which makes studying for pharm questions incredibly annoying. I am not a huge fan of pharm, but I do see the value in knowing what certain drugs do off the top of your head. The major problem is that there is an iPhone app for that and teaching us the pharmacokinetics and drug interactions seems pointless when we get on the wards, shun our knowledge and use Epocrates.

Then there are the lungs...

I like breathing, it keeps me going, but I care little for the mechanics and physiology of breathing. Its negative pressure, there are multitudes of bones, joints and muscles involved in the process. I am so over it. Although there is a heavy dose of pathology, which is always nice, the same 5 bugs show up which apparently cause everything, including stupid, stupid pneumonia. I suppose the good news is that we were taught about antibiotics in pharm last year so we didn't have to deal with learning them again, the bad news is that we have to remember them now. We deal with fungi again, for the 8th time. Aspergillus, Histoplasmosis, Coccidiodomycosis and blastomycosis? Never heard of those before *sarcasm*. TB makes a comeback as well. Asthma, emphysema and COPD show their heads in this unit, and you'll be oh so thankful for it *sarcasm again*. At least pharm is tamed for this unit, that's possibly the only good thing. That and when our class moves on the the next system.

Until next time

Whoop Whoop


PS- XBOX is to cardiology as board games with your parents are to respiratory