uptight secretary working for large bureaucracy

The very first step to success in any occupation is to become interested in it
-William Osler

I realized today that I'm graduating soon. As much as I try to pay attention, I'm guilty of cruising around on autopilot most of the time. So tonight, while in the process of compiling the necessary paperwork to write my MCCQE Step 1 Qualifying Exam and cursing all the busy work of getting my application together to write the exam, I thought about how I'm pretty close to finishing my time as a student. I know the busy work and the applications won't end when I get my degree, and that being a resident still counts as being a learner (and thank goodness for that), but I'm ready to move on.

It's a relatively common for doctors to have a fair amount of self-pity. I remember when I was getting wheeled into the OR for my ACL repair while I was still a medical school hopeful, the anaesthesiologist quiped about my interest in medicine (which my father had let him know about), asking me if I was sure there wasn't still time to switch to dentistry, or something where I wouldn't have to work as hard and could make a decent living. I have to admit that I've been guilty of the same sort of comments. My old housemate Trevor, who is my age, is currently in the application process for medical school. I'm confident he would make a great doctor, but find myself sarcastically warning him off the medical path. As he told me how an experience ski patrolling made him really excited about the possibility of one day being an ER physician, I started asking him if he'd thought about being a paramedic.

Because I'm prone to this sort of behaviour anyhow, and the culture I'm a part of reinfroces it, I have to snap myself out of my aforementioned auto-pilot-like-state and think about where I am. So the exam application made me do that tonight, and now flipping from self-pity to self-aggrandizing, I'm still pretty stoked about medicine. I still like seeing patients, I still feel like I'm doing something worthwhile and I'm excited about the next stage of my training.

There's lots ahead of me still before I graduate, including a cross-country interview tour, a 2-day OSCE and the MCCQE, thrown in with 3 more clinical electives, but they'll be out of the way soon enough, and I'll be moving somewhere on July 1st to start the next part.

useless hooky

Pain is temporary
-Lance Armstrong

Believe it or not, the picture on my UBC medical student ID often garners comments that I look like Lance Armstrong. I managed to find my ID photo online so you could judge for yourself. Sidenote- it's somewhat difficult to find an image of Lance Armstrong where he's not on his bike and has clothes on where he isn't juxtaposed with some blonde woman. Double sidenote- is he really dating Mary Kate/Ashley Olson? Weird.

Anyhow, so what do you think?

Okay, I'm blurrier than Lance, and it's a little far-fetched anyhow, but it's nicer than being told how young I look, or just being ignored.

Last week we started our Principles of Medical Practice (PMP) course. It's 3 weeks long and is meant to cover things that we will have to know for our residency and beyond, but haven't learned yet on wards. Some parts of it have been great. There have been good lectures on ethics, likelihood ratios, radiology, etc that I've found very useful. I am also continuing to enjoy the regular schedule, time with friends and return to extracurricular activities.

One of the main problems I've found with the clinical years of medical school, is the unpredictabile nature of your life. On one hand, this causes stress when showing up to work, as you don't really know who you're working with or what will be expected of you on many days of the year. Moreover, your schedule is often released last minute, or changed at random without your consultation, making it difficult to plan much of anything. Even though many rotations give you enough time to do other things, you can't really organzie anything.

The point of that long complaint is that when you get back into a regular schedule, and in touch with your colleagues (we're supposed to call eachother "colleagues" now"...it's more professional), you can actually do things you like again. For me, this has included rock climbing, squash, soccer and snowboarding so far. It's been lots of fun to get back to this stuff, but it also means I've been in more or less constant pain from muscle stiffness for the past two weeks. I must be getting old.

We had a session led by a physiotherapist earlier this week which was quite topical to my own pain predicament. The goal of the session was to enlighten us on the treatments physios use to rehab patients with musculoskeletal injuries. Physiotherapists can be quite diverse in their practice and will often use some dodgy techniques/devices in rehab. Personally, I went to a physio regularly after hurting my knee snowboarding in undergrad. They would spend 1/2 hour running electrical current through my leg "to speed up the inflammation and get it over with" before icing it. Anyhow, bygones aside, the guy we had was pretty legit and only used therapies that had some sort of evidence to support them. He does use manipulations (cracking your various joints, especially the back, to help with muscle tension) although he admitted that it only provided very short-term benefit.

On one hand, I was wondering why he would spend time doing manipulations if he knew it didn't really work. On the other hand, I've had my lower back manipulated once before by a physio, and let me tell you, it feels good. Unfortunately, he didn't do a demonstration. I would've been right in there.

Anyhow, it's up to Whistler on saturday, squash again on sunday and then maybe soccer again sometime next week at least. I've got an expired bottle of crumbling ibuprofen by my bed.