“For happiness one needs security, but joy can spring like a flower even from the cliffs of despair” – Anne Morrow Lindbergh

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Too often, we find ourselves trapped in the mindset of “have to.” I have to go to work. I have to study. I have to go see the new patient in room 6. I have to make time to workout. I have to meet up with my friend for dinner.

I know I am not alone in this.

We, professional students, get caught in the whirlwind of our responsibilities and our interests. To-do lists that stretch far too long down the page serve as our lifesource. We are unfailingly hardworking. We schedule naps. We schedule social time. We fail to be spontaneous.

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“Success is a science; if you have the conditions, you get the result.” – Oscar Wilde

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Is it just me or is 2017 going by extremely quickly? I cannot believe that tomorrow is the first of April. April is my last month of core clinical rotations. This year of medical school has been crazy. I feel like I mention in almost every post that medical school is hard. Each year in medical school has its own challenges. Third year is the awkward balance of two time-consuming roles: full-time student and health care provider. Each rotation comes with very different schedules (some schedules change on a weekly basis, others change every few days) and expectations. My biggest challenge has been to balance my work on the wards and to keep on top of my academics (there’s always a shelf exam on the horizon) and personal obligations (appointments and engagements).

I can easily say that the key to my sanity as a medical student is how I organize my day to day.

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How to Survive Medical School: Pediatrics, Psychiatry, and Neurology

The third out of eight weeks of OBGYN is coming to a close. Don’t get me wrong, I really enjoy deliveries (yay to babies) but my mind is on what follows this rotation.  Make sure to follow along with my day-to-day life on Instagram and Twitter. Just a heads up: I have a really neat giveaway planned for next week. I have a feeling you guys are going to love it! 😻

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Okay so before I jump into my recommendations for each rotation, here are some other spots with pretty amazing clerkship advice.

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“Memories have huge staying power, but like dreams, they thrive in the dark, surviving for decades in the deep waters of our minds like shipwrecks on the sea bed.” – J. G. Ballard

I have found myself caught by the inescapable vise of nostalgia. There’s a trend. It is often when thoughts of the future overwhelm me that I find myself retreating to the past. This is an extremely happy time. The results of Match 2017 were revealed yesterday. I am extremely happy for my dear friends as they move forward in their journey to be health care providers. This is an extremely unnerving time. Many of us in the class of 2018 are weighing a lot of major (at least they seem major right now) decisions: what specialty will make us happy, should we even participate in Match 2018, research year, away rotations, sub-I, STEP 2CS and STEP 2CK — all while wrapping up MS3 year. It’s a lot!

I’m made a few of the major decisions. I plan to go into pediatrics. I have scheduled STEP 2 CS and STEP 2 CK and they feel like they are coming up ridiculously quickly. I’ve registered for my MS4 coursework, but I’m sure I’ll have to make some changes. 😸

I’m in the process of finagling VSAS in hope of landing an away rotation. I don’t even want to think about my sub-I right now; I’m still just trying to get a handle on the rotation I’m on: OBGYN. Full disclosure: I spent two of my hours on call in the CBD eating lunch and enjoying affogato so it’s not like they’re killing me. 😸

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I had a really heartwarming conversation this morning with a member of the ancillary staff moments before I had to scrub into a C-section. She asked me: “how long would it be until you’re a pediatrician?” I answered: “Fours years. One more year of medical school and three years of residency. If I sub-specialize, that will be another 2-3 years.”

She responds: “It’s a long journey!” I responded non-verbally. Maybe I gave a sigh followed by an uncomfortable laugh. “At the end of the day,” she said, “it will all be worth it. I’m so proud to see a smart black woman in this field. Keep it up my dear. Keep going.”

There’s a trend. It is often when thoughts of the future overwhelm me that the words of a kind stranger restore my hope.

Five years ago, I had an unexpected albeit restorative conversation with a homeless man in Denver . We discussed politics, homelessness, medicine, art, and our hopes for the future. Before we parted ways, he gave me a hug and said: “You are going to be an amazing physician.” I remember crying, I was so moved, when I made it back to my apartment. I remember crying even harder, I was so distraught, when I came to realize he passed a year later.

These words of encouragement have been such as source of comfort. For those of you who are also juggling feelings of excitement, anxiety, and doubtfulness, I have faith in you. We can get through this. One day at a time.

“I am tired of knowing nothing and being reminded of it all the time.” – F. Scott Fitzgerald

Four core rotations down. Three more to go. Today marks my second week of clinical duties on the psychiatric ward. It’d be a lie to say I’m not nervous about this rotation in particular. I mentioned some of my anxiety to one of my colleagues today and he responded: “oh c’mon, Ajibike, you’re always nervous at the start of a new rotation.” To an extent, he is right. There’s an overwhelming sense of I know nothing that accompanies the start of each rotation. It seems as though the moment when I feel comfortable on a new service is exactly when it is time for me to move onto a new team.

Everyone who knows me knows that I love F. Scott Fitzgerald. Many of his works are fixtures in my list of favorite novels. When I stumbled upon this quote, I knew it would serve as an honest introduction for this post. This quote = mood.

MS3 is the year during which you amass a ton of clinical knowledge.

MS3 is the year during which you learn to not “sweat the small stuff.”

A MS4 told me at the start of my MS3 year that I should be prepared for moments when 150% effort will be rewarded with an evaluation that reads: “Good student.” She told me that it’s important to hold learning the art and practice of medicine as my main priority rather than impressing attending and resident physicians. Unsurprisingly, I followed her advice with: “Okay…I hear what you’re saying but what can I do to be a good medical student.”

She gave me three pieces of advice that I still find incredibly valuable:

1. Know your place.

2. Take ownership of responsibilities related to your patient(s).

3. Present well.

What does it mean to present well? Each discipline has their own twist on the history & physical or SOAP note…but at the end of the day, a good presentation is: concise, thorough, and accurate.

The major 🗝 to a good presentation is: organization. On my first couple of clerkships I made my own templates to record information on each of my patients. I also toted around an myriad of documents (physical exam maneuvers listed and described and an extensive review of systems). On each team, I learned what my attending wanted from me and adjusted my presentations accordingly.

I felt a lot of pressure when I started my pediatrics rotation. I came into medical school with an interest in pediatrics and so when the rotation rolled around, I wanted to impress my attendings. At that time, I got my hands on a Perfect H&P notebook.

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This notebook fits in a white coat pocket and is affordable – only $15 guys! The notebook supplanted all of the documents I was carrying around in my pockets. I’ll talk a little bit about how the notebook is constructed in a moment. I will say that this notebook is perfect for wards work. Sure, certain disciplines may require a bit more material on topics not specifically mentioned in the notebook. I’d say that this notebook is a great organizing tool for internal medicine, surgery, family medicine, and pediatrics. I can’t speak to neurology or OB/GYN as I haven’t completed those rotations yet. I will say that I don’t think the notebook is as helpful for psychiatry.

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The template has checkboxes for basically ALL the physical examination findings and symptoms (for review of systems) you could possibly want. I will say that the section for laboratory results is on the small side.

One aspect that I really appreciated is the sect ion for differential diagnosis. On so many rotations, I haven’t been required to present my differential for each aspect of the problem list. That’s honestly been a disservice to my education but I’ve found that  forcing myself to think of a differential (of at least 3) has helped me to present more sound assessments and plans.

I’m hooked on this notebook and I fully intend to pick up another one before I start my sub-I in June!

If you guys have tips and tricks for presenting on the wards, I’d love to see them in the comments below!

Disclosure: Perfect H & P provided this notebook for free to be reviewed on this blog. All opinions are my own. 

“Here’s to the unknown, the smiles and the tears and the laughs we haven’t had yet.” – O.L.

Happy New Year’s Eve everyone! The quote that serves as the title of this post is an excerpt from a poem I discovered earlier today. Simple in its construction, the poem has great depth. I want to share the poem, “Honest Toasts for the New Year” in its entirety before I dive into the rest of this post.

New Year’s Eve and we are all
holding flutes of cheap champagne,
with people we don’t know
or don’t care for, or we wish we could
just leave behind with this year
and we are all toasting,
glasses raised above crooked halos.

Here’s to the friends we lost,
the friends that left us behind,
the friends we haven’t met yet
and the friends that are bound
to be more than.

Here’s to the knives wedged
between shoulder blades
and blood slick ribs,
grazing our hearts as we breathe.
Here’s to the pain
that made us stronger.

Here’s to the resolutions we didn’t keep,
the ones we will make again
and again and again,
but habits are hard to break.
Here’s to consistency.

Here’s to the lips we kissed,
bruised, bit, lavished
and all the lips we will come
in contact with in the future.
Here’s to love.

Here’s to the scars
and the pieces of ourselves
we had to cut off to make it,
the fractures of glass that we are leaving
in this hellhole of a year.

Here’s to the unknown,
the smiles and the tears and the laughs
we haven’t had yet.
Here’s to next year, the New Year,
hopefully it will be better
and we will learn just as much.

Feel free to read the rest of O.L.’s poetry at this link.

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How to Survive Medical School: Internal Medicine, Family Medicine, and Surgery Clerkships

I cannot believe I am saying this: I just finished my fourth rotation ¡Adios Internal Medicine! Sayonara Family Medicine. Goodbye Surgery. I’ll miss you pediatrics!  MS3 is going by extremely quickly and as hard as this year is – one of my favorite internal medicine residents told me it’s “a year that requires grit”– I’m a bit sad that things are winding down.

Before third year set off, I spent a lot of time reading the advice of medical bloggers and anonymous med-redditers. I found this advice extremely helpful and I just wanted to share how I approached each clerkship.

MS3 is extremely different from MS1 and MS2. There is a delicate balance between preparation for the wards/clinics and preparation for the end-rotation shelf. It’s hard for me to give concrete advice about how to strike that balance. Believe me, it will get easier with time. In this post, I’ll share what resources made internal medicine, family medicine, and surgery survivable.

If you’re looking for more advice, these are some pretty great places to check out as well.

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White Coat Wardrobe: Blue Crop Top Edition

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Today marks the halfway point through my pediatrics rotation. I’ve spent the month in the outpatient clinics: two weeks on subspecialty (pulmonary, allergy/immunology/rheumatology, and endocrine) and two weeks in the general clinics. This weekend, I’m heading up to Lafayette to start my inpatient services (PICU, wards, nursery). I can honestly say that I’ve enjoyed every single day of this rotation thus far.

Sometimes I get messages from medical students who haven’t started clinical work yet about what I wear to clinic. You probably guessed but most of these students are female. What is considered appropriate? Where can you find affordable albeit professional attire? I’ll try (I’m not making any promises here!) to do a better job of sharing what I wear to work on the blog. Let’s start with a throwback.

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How to Survive Medical School: USMLE 1

This past weekend marked the halfway point of clerkship (MS3) year. This past weekend also marked yet another weekend that flew by without a blog post. I promise that I’ve drafted and edited posts in what little spare time I have. Third year is exhilarating albeit exhausting – a topic I’ll touch on in a post to come. Today, I wanted to share just a little bit about my preparation for USMLE 1 and some general advice for the big exam.

I often get emails and direct messages (on Twitter and Instagram – you guys are relentless) about USMLE 1 and my score. I have never been the kind of person to share specifics regarding standardized test scores but I will say this: I only took the advice of upperclassmen who scored 245 and above. And so, I would take my own advice.

To preface my advice: you know yourself best. At this point, you’ve come to understand what sort of student you are. You know how to prepare for standardized tests. USMLE 1 is no different from the MCAT or SAT/ACT/AP. Don’t forget that!

The worst thing you can do is get into your head. I think a lot of medical students get so worried about the exam and freak out (preemptively) about their ability to match into xyz specialty that they forget that it’s just a test. An important test, but still…just a test. With that in mind, the best advice I can give is to try your hardest to learn material well the first time it is introduced.

One of my classmates took extra time off to study for USMLE 1 and of course when we caught up to chat, I asked him why. He told me: “I took pass/fail at heart first and second year, and so I had to teach myself a lot of material for the first time. I just needed more than 6-8 weeks to prepare.” Totally valid.

Before you launch into this post, take a peek at my general approach to MS2 and how I handled each MS2 course.

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