THe currency of Med School

In medical school, certain things are more valuable than otheres. Much like second graders bartering lunches away, Med students swap valuable things, which on the outside may not be as valuable.

Typed lecture transcripts, excel spreadsheets of micro bugs, Anki flashcard decks, these are the high value objects. They are shared amongst fellow students like pinworm in kindergarten.

Insomnia?

Recently, I have had problems getting to sleep.  I don't know if it is clinically insomnia however.  Typically, the problems I am having is getting to sleep.  Mostly, a few weeks ago, I was going to bed at a 'normal' time of around 10 or 11 and basically lying in bed thinking, "I should be doing X, Y, Z..."  Then, I would not actually get to sleep until 2 or 3 in the AM.  I finally decided that this wated 3-4 hours could be spent in productive activities.  So, against my better judgement, I decided to wait to go to bed until I felt I was absolutely about to pass out.  Now, my sleep schedule has shifted to going to sleep around 3 in the AM and getting up between 9 and 11.  (Note, that classes are held in my program from 2-6 in the evening.  So, this schedule works for when I need to be places).  I have started taking melatonin supplements to get to sleep when I need to, but often feel snowed the next half day after taking these.  I don't have any big revelations about this, I'm not sure quite what to make of it.  Is this normal?  Will I regret the decision to shift my schedule later?  I'm not sure yet.  Should I sacrifice sleep in order to to do more work.  I know that learning is not converted to memory until you sleep on it.  So, in some ways, cutting down on sleep is going to cut down on my learnin
g, right?  I won't know the answers till after the next exam... Based on the results I will be able to tell you how it worked.

Everything you do is for the purpose of MedSchool....

In Medical School, everything you do is for the purpose of success on the next exam.  If you sleep, eat, take a nap, watch a TV show, visit with family, it is usually for the purpose of recharging yourself for the next bout of studying.  While I do still do a measured amount of leisure activities, they are all done for the purpose of taking a break and recharging my batteries for the next round of effort.  Leisure is not done for just the purpose of leisure.

Something I've been struggling with

I haven't been in a true classroom situation in several years.  What I remember from my undergrad is that people don't like people who always answer the questions the profs ask.  I'm not saying that I always answer the questions they give correctly, but as I do sit in the front row, it is easier for me to propose an answer.  Sometimes I feel like I am the only one who tries to answer these questions.  Part of my learning curve the first week was to realize when I was sure / not sure if I knew something.  I certainly blurted out some dumb answers.  For example, I said that glucose would be transported by facilitated diffusion.  Wrong-o!  However, I do have more experience than many of the people in the class and because of that I probably do have a more in-depth knowledge on certain topics.  These guys will have an additional 10 years of doctor income that I won't have so I might as well get in a few right answers, eh?    I also am wondering why I feel the need to answer the questions at times.  Why don't I just keep the right answer in my head and not feel the need to call it out?  I think part of it is that I have had a bad run, recently and sort of need the confidence.  I need to feel like I know what I am doing.  Another aspect is that having been a teacher, I know what the emptiness of blank stares feels like.  I feel like I am helping out by proposing the right answer to a question.  Getting up in front of a large class of blank faces is nerve wracking no matter how often you do it.  There always will be some aspect of nerves.  So, in my mind anyway I am helping out the prof by showing that I am actually listening.  Whether or not the prof perceives it this way I will never know.  Finally, In this program we are all auditioning for getting into MS1 next year.  So, I feel like if I am interactive and perceived by the profs as being somewhat not-braindead. Then, if they influence the admissions decision at all, it might give me a bit of a leg up.  However, there is the chance that if I am too aggressive in answering questions then I may alienate possible alliances with peer groups and the profs would notice that too.  They might think I have no social skills, or a big ego.  Part of it also is that I have very little fear of public speaking after teaching for awhile, so I'm not afraid to say the wrong thing.  Others may be struggling with this.  There has to be a fine balance there somewhat.  For sure, I have sat on some answers to questions just because I don't want to be the one that everyone dislikes in class.  And, like I've mentioned before I have a distinct advantage in that my assigned seat is in the front row.  I can imagine that someone all the way in the back may not even be able to be heard by the prof.

I guess I will take it as a blessing that I feel I know most of the answers to questions profs ask in class; with the understanding that I need to strike a balance between not answering all the questions and also not being totally silent.

PS I'm almost certain that this is something that a Guy would not even consider as a problem.  I think it is part of the female conditioning process to be told that you have to be quiet / demure / retiring.   "Oh, golly I just don't know; my female brain just can't handle this hard stuff.... "  I think females do this to other females more so.  If one female ignores the social custom of not speaking out the others will respond negatively. 

Reflections on this past month...

First of all, I have learned SO much.

While working in a neuroscience research lab, and also in a pharma company, I became very familiar with a narrow range of disease states, Parkinson's disease, Schizophrenia, Bipolar disorder, and the cellular processes and principles related to those disease states.  The basic science principles I have learned in the past few weeks has ultimately helped me to understand to a greater extent what I thought I already understood. 

Second, I have met so many interesting people

I am lucky that my assigned seat in class has me sitting in the front row.  I am also lucky that I like the people who are assigned to sit immediately around me.  I thought I would be the only person over 30, but that is not the case.  There are even people older than me, (not many though).  There has been culture shock at time when the younger students may not get a reference or two.

It is hard to believe that it has been about 6 weeks since this program has started.

Everything you do is at the cost of something else you might have been doing

First full week of med school classes down.  First real med school test down.  My goal is to get a 4.0 this semester and next; while that might be a lofty goal, I feel that with my experience and also with the awesome setup I have as far as technology, free time, etc... I should be able to attain that goal.  I have found a study group of four other married and "old" (over 25) med students.  We met informally a few times last week and formally in a coffee shop this past Saturday.  We decided to make up possible test questions to quiz each other with and that seems to help.  I think we will continue doing that at some sort of interval, not sure when yet, still working out the details.  What I noticed when I was studying for this first test is that everything I do (sleep, eat, gym, laundry, groceries, Stargate Atlantis etc...) is at the expense of something else.  This is true of anyone, if you watch Judge Judy you can't be watching Dr. Phil.  (well unless you have DVR or two TVs etc...) But you get my point.  There is such a time requirement with med school (e.g. reading 9 chapters of Guyton and Hall in 3 days) that you can't possibly get it all done unless you are on some super stimulant medication and then I'm not sure if the DOING would convert to REMEMBERING.  So, we're left with prioritization.  I'm in the phase where I need to figure out what activities gain me the most points on the test.  Do I get the most learning out of reading and outlining chapters?  Re-listening to lectures?  Does going to the gym occasionally actually help me in that it is healthy for my body and thus helps with life support for my brain.  I think I have decided that reading the chapters is not as value-added as perhaps focusing on lecture material.  I do however think that I should have focused more on making flashcards earlier in the game and started learning from them each night.  After the test, I did some much neglected tasks such as grocery shopping, laundry and a general tidying up of my apartment.  Basically hitting the 'reset' button for next test.  Doing these tasks has meant that I didn't review Monday's lecture as thoroughly as I might have or should have. 

How did I feel about the test.  First of all I feel like I studied my BUTT off.  I'm not used to getting a good grade on tests all the time.  But I am used to, if I put forth the effort I did on this test I should feel very comfortable with the material and like I for sure got an A after.  I don't feel that way.  In fact I know I missed some questions.  I knew going into it that med school is hard and the tests are hard.  I thought the hardness was more so from volume of information.  It seems to me that some of the test questions were intentionally tricky.  Without saying exactly what the question was, one question involved multiple facts, (5% D5W is iso-tonic and then becomes hypotonic as it is metabolized, the interstitium is 2/3 of total body water while the ECF is 1/3....)  Simply knowing these facts doesn't mean that you would have necessarily chosen the right answer.  What I am saying is that the questions were multi step and if you didn't get all the steps right, you wouldn't have gotten the question right.  Similar to a math problem with multiple choice answers I guess.  You don't get partial credit.  Another factor affecting my test was timing.  You get 90 seconds per question.  Going into it I thought that was ample time.  On the MCAT you only get 60; and next year we will only get 60.  When the proctor announced that we were halfway through I was only about 35-40% through the questions.  I rushed to the end of the test, filled in my scan-tron bubbles and then worked backwards through the questions I rushed through in order to check for any mistakes I might have made while rushing.  I did change maybe 2-3 answers at that point.  (they say never change an answer on a test and I have told my students not to do so multiple times)  There is another answer that I wish I had changed but didn't.  Finally, this test does not comprise as many questions as a 'normal' test would in this program.  The test was only over 6 (4 hour) lectures rather than the typical 8.  Consequently, missing just a few problems in each topic (physio grade is counted separately from bio-chem etc...) would mean that your percentage points drop dramatically.  I think I figured that you could only miss 4 physio questions to still get an A.  While this is also sort of a good thing in that not a huge amount of the total questions for the semester were on this test, if one were to go solely on points, this might be a problem. 

At any rate, the AA for the class now goes and runs the scan-trons through, and there is a slight chance that they might throw out questions that a lot of people miss. This would work well if it is a question I also missed but against me if it is a question I got right, by lowering the points possible.  I hope I am worrying about nothing, but I feel like I did not get an A in all categories. 

Two quotes seem appropriate for me at this point:
"A failure is a success if you learn from it" - Malcom Forbes and

"I am a human being, not a human doing. Don't equate your self-worth with how well you do things in life. You aren't what you do. If you are what you do, then when you don't...you aren't." - Dr. Wayne Dyer

So, even if I feel I could have done better on this test, if I figure out what I did wrong and don't make those mistakes again, it would still be a worthwhile learning experience.  And, even if I do poorly, I am more than just a test or a med school.... yada yada yada

When we go over this test on Thursday I am going to try to find out why I missed each question and come up with how I can fix this problem in the future.

First week complete!

Thanks for kicking me in the pants, NP Oddysey!

Orientation started last Wed, which we had two days of.  I think the best part of orientation was seeing OMM demonstrated. 

The format for classes is four hours of one subject at a time.  We have had three physio lectures so far.  All seem to be review with a few clinical anecdotes thrown in there.  However, the review now is what I may have learned in one 'test' unit in one day rather than over several days.

I was pretty broken up at the beginning of last week over having to be away from my husband and kids.  In some ways it is good because I get more alone time than I would normally.  Most of the other married students have their spouses move with them, but it is not possible for us. 

We have our first test next monday.  I am almost done reading all the chapters, and have an outline typed up to which I plan to add class notes, and then input key facts into a flash card software to study with.

Also I think I have found myself a study group, and should be meeting with them tomorow eve.

I also really like the LECOM Fitness Center.  I think it is the best fitness place I have been in.  I have no idea what they charge the general public to use it, and don't want to know.  It has an awesome locker room, with all the ammenities.  You don't have to pay extra for classes, and they are always doing some sort of 'fun' fitness activiites.

This is of course in accordance with the DO philosophy of staying healthy being the best medicine. Mind-Body-Spirit
....
I don't have any great deep personal revelations yet, I will update you when I get one!