Well, this Monday afternoon is my first exam in medical school. There is a clear air of anxiety about us first years. In my personal opinion, the anxiety level was actually highest at the beginning of the week. This was the time when most of us realized that we hadn't been studying either enough, or efficiently, or both! The hand is what drove it home for us.
You see, this block we are learning the back and the upper limb. That means that we have to learn all of the muscles of the back, the shoulder, the forearm, and the hand. For most of these muscles, we also need to know their origins (the places they connect and have little movement) and their insertions (the places they connect and cause movement to occur), as well as their innervations. Add onto this a knowledge of the fascia, major arteries and veins, etc. and you can imagine that we are feeling overloaded. Oh yeah, and the course is called Gross Anatomy, Imaging and Embryology; so that means we have to read some basic x-rays and also know a whole bunch of embryology stuff too.
So, about the hand, it has 19 muscles for us to learn. We learned them all in one day. To give you a comparison, the forearm also has 19 muscles, which we did in 2 days. The shoulder and back have 19 as well (kinda crazy coincedence, huh?) and that was spread out over even more lectures. So, when we got to the hand we all felt overwhelmed. For example, there are the flexor pollicus longis, flexor pollicus brevis, extensor pollicus longus, extensor pollicus brevis, abductor pollicis longus, abductor pollicis brevis, adductor pollicus and opponens pollicus. Eight muscles just to move your thumb!
I feel like my brain is going to explode. I am trying to find solace in the fact that first year medical students historically do very well on this first exam. Still, trying to keep it all straight is a challenge.
So enough about academics, I have some interesting news for those more faithful blog readers (all two of you!) We have to keep a journal for one of our classes and this blog seems to be a perfect way for me to accomplish that. I will be writing about some of this principles of clinical medicine (i.e., actually practicing medicine) and how I experience them through this class and through my work with my preceptors. I'm sure it will make for some interesting reading.
Saturday, September 13, 2008
Sunday, September 7, 2008
Week Two
Week two is over. Because of the Labor Day holiday on Monday, we still haven't had a full week yet. Amazing. It feels like I have been in school forever, but there have only been 6 days of classes. We have learned more information in those 6 days than I have learned in most of my semester long classes from undergrad. Med school does indeed take over your life.
It is interesting to look around and see how all of us are doing so far. I am particularly impressed by the parents. How do they juggle all of this?
So, you want some good stories, right? Well, I don't think I have any wonderful narratives to give you today, but I can share with you some observations from the ever interesting cadaver lab.
1. Underarm fat looks worse on the inside than on the outside.
2. When dissecting the armpit, it is best to hold your cadaver's hand. It may feel strange, but it is better than letting the cadaver's arm drape around your waist (they have wandering hands!)
3. Superficial veins are superficial, not located next to the bone. (I got it pretty bad for making that mistake!)
4. People will give you dirty looks if you go into any common area wearing your cadaver clothes. This is a great way to make a bad impression.
5. Don't leave your cadaver clothes in the trunk of your car. Even more importantly, don't leave them in your friend's trunk.
Anyway, that is all I have for now. I have to go back and finish reviewing my flashcards for the night.
P.S. Getting tipsy and reading literature to your significant other late into the wee hours is a wonderful way to spend a night.
It is interesting to look around and see how all of us are doing so far. I am particularly impressed by the parents. How do they juggle all of this?
So, you want some good stories, right? Well, I don't think I have any wonderful narratives to give you today, but I can share with you some observations from the ever interesting cadaver lab.
1. Underarm fat looks worse on the inside than on the outside.
2. When dissecting the armpit, it is best to hold your cadaver's hand. It may feel strange, but it is better than letting the cadaver's arm drape around your waist (they have wandering hands!)
3. Superficial veins are superficial, not located next to the bone. (I got it pretty bad for making that mistake!)
4. People will give you dirty looks if you go into any common area wearing your cadaver clothes. This is a great way to make a bad impression.
5. Don't leave your cadaver clothes in the trunk of your car. Even more importantly, don't leave them in your friend's trunk.
Anyway, that is all I have for now. I have to go back and finish reviewing my flashcards for the night.
P.S. Getting tipsy and reading literature to your significant other late into the wee hours is a wonderful way to spend a night.
Monday, September 1, 2008
Week One (truncated)
So, today is Labor Day and I am finally feeling like I have a moment to work on the blog. It has been pretty busy so far, but it is certainly manageable for the moment. OHSU doesn't throw you into the deep end first. As a result, once our orientation was finished on Tuesday, they gave us a day off to prepare for class. We had lecture and lab on Thursday and Friday, but then it is Labor Day weekend...so we have Monday off to catch up if we underestimated the workload (or were just studying inefficiently). It seems like a very considerate way to introduce us all to the grind.
However, after today, the kindness ends. In the second week, we will add a second, semester-long, class coming where we learn our clinical skills and also work in a doctor's office. This will take up two precious afternoons a week, plus a minor amount of study time. I am finding Gross Anatomy, Imaging and Embryology (the hardcore, academic class we started the first week) to be manageable, but when the Principals of Clinical Medicine class is added, there will be precious little time left. That is how they get you in med school. It isn't that the material is so hard, there is just so much of it and not enough time.
So that is the summary of what is happened. Onto some details...
Cadaver Lab - First Day
On Thursday, after our lecture, we went down to work on our cadavers for the first time. This necessitated us changing out of everything we were wearing (underwear and socks too!) and putting on a pair of ill-fitting scrubs. My pair were made for a 6 foot tall, 300 lb man. The top is a very unattractive, button-up smock and the whole thing is maroon. I look like a blood clot.
We all got down to lab and proceeded to get gloves. I overheard people discussing double-gloving it and I followed suit. We went over to our cadaver, an older woman who is very thin and frail, and began to decide how we would proceed. The first order of business was to remove the skin from her back. Now, the thing is, none of us have done this before and none of us really know what we are doing. As a result, we had no leader. In addition, the lab book at our table was from five years ago, so the pages numbers didn't match, and we were given instructions in class that contradicted some of these instructions anyway! Needless to say, chaos followed. After making a number of unnecessary cuts, we finally started making progress. However, we had to remove the skin from the body. This is when I remembered reading that the number one dissecting tool is...your fingers. So, I dove in with my hand and proceeded to do separate the skin from the fascia. Soon, everyone in the group joined in on this gruesome task and we were successful, somewhat. It turns out we were not deep enough and had to remove all of this fascia and fatty tissue in order to expose the musculature. No worries though, we eventually got there. Being older though, our cadaver barely has any muscle left. Her lat muscles (the huge Michael Phelps swimmer muscles on our sides) were as thin as tissue paper.
After lab, I sat with some classmates at lunch. Few were able to eat right away, but I had no problem. Apparently, not everyone double-gloved, so whenever my friends went to eat their sandwich, all they smelled was the cadaver lab. Yum.
Keep Your Mouth Closed
On day two, we worked on exposing the spinal cord. This was an even more gruesome task than the day previous. Let's just say it involved chisels, mallets, and a tool called the "bone pliers." So, we were having difficulty actually removing the spinal processes (the little spines you can feel through your skin) and had the professor come over to show us. I was looking over his should and my mouth fell open in amazement as he started to expose the cord. At this time, a bunch of spray came up from our cadaver and landed all over my smock. Just a couple of inches away from my wide open mouth. The professor proceeded to tell me that this is why we keep our mouths closed when dissecting. Point taken.
Well, that is enough for now. I need to get myself going and do some studying. I will try to post again next weekend and summarize week two. It seems we are having a Bone-A-Thon up at school for Labor Day. It looks like days off are a thing of the past.
However, after today, the kindness ends. In the second week, we will add a second, semester-long, class coming where we learn our clinical skills and also work in a doctor's office. This will take up two precious afternoons a week, plus a minor amount of study time. I am finding Gross Anatomy, Imaging and Embryology (the hardcore, academic class we started the first week) to be manageable, but when the Principals of Clinical Medicine class is added, there will be precious little time left. That is how they get you in med school. It isn't that the material is so hard, there is just so much of it and not enough time.
So that is the summary of what is happened. Onto some details...
Cadaver Lab - First Day
On Thursday, after our lecture, we went down to work on our cadavers for the first time. This necessitated us changing out of everything we were wearing (underwear and socks too!) and putting on a pair of ill-fitting scrubs. My pair were made for a 6 foot tall, 300 lb man. The top is a very unattractive, button-up smock and the whole thing is maroon. I look like a blood clot.
We all got down to lab and proceeded to get gloves. I overheard people discussing double-gloving it and I followed suit. We went over to our cadaver, an older woman who is very thin and frail, and began to decide how we would proceed. The first order of business was to remove the skin from her back. Now, the thing is, none of us have done this before and none of us really know what we are doing. As a result, we had no leader. In addition, the lab book at our table was from five years ago, so the pages numbers didn't match, and we were given instructions in class that contradicted some of these instructions anyway! Needless to say, chaos followed. After making a number of unnecessary cuts, we finally started making progress. However, we had to remove the skin from the body. This is when I remembered reading that the number one dissecting tool is...your fingers. So, I dove in with my hand and proceeded to do separate the skin from the fascia. Soon, everyone in the group joined in on this gruesome task and we were successful, somewhat. It turns out we were not deep enough and had to remove all of this fascia and fatty tissue in order to expose the musculature. No worries though, we eventually got there. Being older though, our cadaver barely has any muscle left. Her lat muscles (the huge Michael Phelps swimmer muscles on our sides) were as thin as tissue paper.
After lab, I sat with some classmates at lunch. Few were able to eat right away, but I had no problem. Apparently, not everyone double-gloved, so whenever my friends went to eat their sandwich, all they smelled was the cadaver lab. Yum.
Keep Your Mouth Closed
On day two, we worked on exposing the spinal cord. This was an even more gruesome task than the day previous. Let's just say it involved chisels, mallets, and a tool called the "bone pliers." So, we were having difficulty actually removing the spinal processes (the little spines you can feel through your skin) and had the professor come over to show us. I was looking over his should and my mouth fell open in amazement as he started to expose the cord. At this time, a bunch of spray came up from our cadaver and landed all over my smock. Just a couple of inches away from my wide open mouth. The professor proceeded to tell me that this is why we keep our mouths closed when dissecting. Point taken.
Well, that is enough for now. I need to get myself going and do some studying. I will try to post again next weekend and summarize week two. It seems we are having a Bone-A-Thon up at school for Labor Day. It looks like days off are a thing of the past.
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