On to the next one

Third was a tough, tough semester, but thank God I passed.  It is considered by many students to be the toughest on the island.  Microbio was really a struggle.   But hey struggles help you reaffirm your motivation for embarking on the journey in the first place.  I excelled in micro in undergrad, but this was a whole different beast entirely.  We are expected to know which media to grow the microbes on, classifications (oxidase, catalase positive or negative, etc.),  which toxins they produce, and signs and symptoms, whether a virus is single or double stranded, enveloped or non- enveloped, segmented or non-segmented, etc.  For microbiology I would recommend relying heavily on sketchy micro, picmonic, or making up your own mnemonics.  With microbiology, you can not simply understand the concepts like with physiology, you are forced to come up with some creative way to distinguish the features of a specific bacteria, fungi, or virus.   The first block, fundamentals, was also heavy on the conceptual fundamentals of pharmacology, such as drug distribution and absorption.  Our other blocks were renal physiology, GI pathology, and reproductive physiology (why do women have to be so complicated?).

Boiling Lake

We made it to the summit of Boiling Lake.  The fog is the background is from the sulfur gas rising from one of two Sulfur boiling lakes of that size in the world (according to our tour guide).  It was worth the couple days of sore legs afterwards. 

3rd Semester

Others students have said that 3^rd semester would be the semester that it starts to feel more medically related and how one would expect medical school to be.  This was not the case initially, but in these past few weeks I have found that sentiment to be somewhat true. For me it has been because of the greater emphasis on our patient interviews and a focus on identifying the underlying signs, symptoms, and treatments used to address a certain disease.  As opposed to the first couple of semesters, when we were more focused on the normal physiological functions of the body, not pathology.  I find myself becoming more excited about beginning rotations later in the (not-so) distant future.

Salybia Mission Project

I got an opportunity to participate in the most popular club on campus, Salybia Mission Project.   I participated on behalf on the special men’s clinic that emphasized prostate health, sexual health education, and occupational injury prevention.  It was by far my favorite club experience thus far.

It is the only club that caters to the Kalinago people, the natives of Dominica.  I was surprised by how large the clinic was.  There was a lunge room, waiting room, and about 10 or more other rooms including a currently unoccupied dentist room.  Our team from Ross included a couple of doctors, a chiropractor, and about 16 students.  At the clinic were a nurse and doctor and other staff that work at the clinic during the week. 

We began by presenting a rectal model to the patients which allowed them to visualize how the digital rectal exam was done.  The model had multiple types of prostates that can be replaced, some with lumps some normal so the patients could feel for themselves.  This was done in hopes of easing the anxiousness of the patients and improve understanding.  And yes, some of us got an opportunity to preform a digital rectal exam.  The patients were very gracious in allowing us to learn how to feel for the prostate on them.  When I first placed my finger into the patient’s rectum, I tried to keep my face straight to no avail, good thing the patient couldn’t see my face.  My finger slid further until I felt lumps as I slide my finger to the left and right.  The first patient’s prostate was more enlarged on the right side. Therefore, the doctor ordered a PSA test to help determine the possibility of cancer.  His case was of specific concern because the prostate was more enlarged on one side than the other.

One of the things that the vast majority of men will deal with, especially men above 55, will be an enlarged prostate.  This can disrupt the flow of urine, which can lead to common symptoms including: frequently waking up to pee at night (nocturia), polyuria, a feeling like the bladder isn’t fully emptied after urination, dribbling of the urine, or a thin stream of urine.  Sometimes these cases are related to an infection of the prostate, which led us to explaining brochures of different sexually transmitted diseases.

Overall, the clinic was a huge success and seemed to run very smoothly. 

Horseback Riding

We went horseback riding this past weekend with Valerie through Rainforest Riding and had a blast.   The rain made me fairly skeptical about whether we would be able to ride, but the guide assured us it would be fine, so we threw on our ponchos and geared up for the ride. I had been on a horse once before, but didn’t ride it very far, so this would be a new experience for me.  I greeted my horse, Lucy, as I hoped on her back.  Lucy was a race horse from St. Lucia in her glory days. 

Our only instructions were to control our horses and follow the stallions.   That would’ve been reasonable, except we had no previous significant experience riding a horse.  I assumed she said control the horse as a formality, as  I would surely be helpless if Lucy decided to take off or buck me off her back, so I took it to mean that the horses were well trained and not much controlling would be necessary.  This proved to be the case.  There were moments when I channeled my memory of horse movies and whipped the rains while yelling “yah, yah”.  Lucy responded by turning around pursing her lips and snorting, as if to say “you can’t be serious right now.”   She would then take a bite off the grass and proceed to move when she felt ready.  Only later did she start to respond to my commands, as I gave her a firm smack on the hind leg.

We split up our big group into two, one group went a couple hours before us, and there were three people riding in my group.   We were instructed to follow behind the stallion and not to pass it, as the stallion has a huge ego and will attack the other horses if “disrespected”. 

We rode up a trail high into the mountains through to an area dense with trees forming a high-rising canopy creating a cooling mist from the rain.  It looked like a scene out of Jurassic Park.  We heard the noisy national birds, a green parrot, with red underneath its wings, as they found shelter in the tree barks.  We caught glimpses of them flying away, flapping vigorously through the wind.  After exiting the canopy, we overlooked Cabrits (two volcano elevations where the remains of an old English fort are located) and the beach.  We made stops along the trail to view sugar cane plantations where Dominican slaves used to work.  We also stopped to collect bay leaves and cinnamon leaves and bark to make tea.  We also ate fresh cocoa off the tree.  The white outside layer surprisingly tastes like a sweet/sour candy while the brown inside is grinded to make chocolate.   It was a great experience, enhanced by the rain.  After all, what’s a rain forest without rain?

Intramural Football

My football squad, now 2-0.  Nice to get some competition and exercise as a study break.  I got a couple of interceptions in the video.

Portsmouth Clinic

On Sunday morning, RAF held a clinic at a local Portsmouth church.  I got my morning boost of energy, not by caffeine, but by this man yelling outside of his balcony at us.  It took a while to understand what he was saying to us, but we figured it out eventually.  He was apparently frustrated because the children at the church had been doing some type of drill activity in the morning called “Pathfinders” so I guess they were making too much noise for him. 

We set up different stations for the “patients” to navigate.  They would start at the check-in where we gave them a check-in sheet, proceed to get blood pressure checked, auscultate for heart and lung sounds, check BMI, and finally go to my station to get their blood glucose checked.  I had to be the bad guy of the day, pricking the tips of fingers to measure the blood glucose.  I don’t know if it was more painful for them or for me, as I had to watch these kids contort their faces in vivid anticipation of a horrible pain that never came.  Most of the patients didn’t feel much.   Other times I may have held the small needle in too deep or too long… oops. 

It’s fun for me to be able to see trends along the patients BMI, glucose, and BP and predict what the sugar will be.   I also get to find out slight lifestyle differences between those with higher blood sugar (fried white flours) and those with lower blood glucose (usually eating provisions, fish, or rice and beans for breakfast).  I keep on anticipating hearing breakfasts more typical to America, but usually their breakfast is not much different than their lunches may be.  A better alternative to the cereals, bacon, sausage, we are used to.  I also noticed that they don’t eat much dairy.

$10 Million Qualcomm Tricorder X PRIZE

There are some exciting new developments brewing in the field of medicine.   As healthcare as a whole tends to be on the conservative side of implementing new technology, it is exciting when new developments come along.  One of these is currently being developed is the Qualcomm Tricorder, a winner of the $10 million prize going to the best developer will be crowned in January 2016.  This Tricorder is slated to be a personal diagnostic tool, something similar to a primary care physician in your pocket.

An initial concern of mine is that the development of personal diagnostic tools such as these might lead individuals to render a primary care physician unnecessary.  These tools may lure patients into an overestimation of the knowledge of the extent of their illness, failing to string together the diagnostic clues that a physician would be able to detect.  Ideally, these tools would be supplemental to regular check-ups by a primary care physician and provide quick and easy additional information during the check-up.  

The creator of Xprise, Peter Diamandis, is a physician who graduated from Harvard Medical School.  However, he always had a keen interest for space exploration, and his first Xprise fundraising event was to help develop the technology used for personal space exploration that is seen today.  His passion attracted the help from millionaires and billionaires such as Tony Robbins and Elon Musk.

Dr. Diamandis' efforts show that you don't necessarily have to have the money to develop great ideas, only the passion and consistency to get others to participate in the fruition of your vision.  He also is another model of the diversity of fields that a physician can enter whether that is technology, design, research, etc.  As the technology in the health care field continues to evolve, we may see a radically different healthcare system years down the line.  Hopefully, this new technology serves as a tool for regular health monitoring and a desire to adopt healthy lifestyles, as will be able to easily visualize any small progression in their health using the hand held device.

520,000 Sandwiches

It's important for us to keep in mind that it doesn't take a huge corporation or backing to make a huge difference in the community:

Good eating

It's been a while since I've had good home-cooked food, emphasis on good.  I haven't developed the patience for prep time, cooking, and cleaning required to cook a decent meal.  Fortunately the advisor of the Ross Adventist Fellowship club invited the members over to her house for lunch.  It was a great time of prayer, fellowship, and delicious food.  

Homework

Earlier this week, our professor gave us "homework".  I couldn't help but smile, because for some reason the word instantly brought me way back to the elementary memories of finger painting, making "pigs in a blanket", naps, Friday fun days, even the more painful memories of peeing on myself on the way to the bathroom (which seemed as far as the moon at the time) and laying there on the grass hoping the sun would dry up the stain and save me the embarrassment.... then my thought process was interrupted by the drugs we just learned about.  I couldn't help but think how in that moment there was either not enough beta-2 receptor stimulation (causing the bladder to relax) or the receptors were already saturated.  Or maybe there was not enough sympathetic alpha-1 receptor stimulation to keep the internal sphincter of the bladder closed in that shameful moment.  Oh how a few pills of Ephedrine would have came in handy.  Nevertheless, the end result was a wet spot on my shorts and yellow socks (TMI?).  To which I think I tried to explain by saying that the grass was wet at that spot I was laying.

Medical school is a whole different beast because of the pace at which we the material is presented.   Inevitably, these subjects keep filling the crevices of my brain, eventually spilling out onto nostalgic memories... something like urinary incontinence.

MD/ MBA Option

I have yet to find official documentation, resources, or links indicating a dual degree opportunity, however a recent graduate from AUC (another medical school owned by Devry) recently told me about an opportunity to obtain a MBA from the Devry Keller School of Management.  This is for students who are waiting to obtain resdidency after graduation.  Supposedly, there is a grant/scholarship deal that the med schools got together with DeVry Keller Graduate School of Management. It pays for a year of online classes ($26k) and 1 year of the MBA has been completed due to credits and classes from medical school.  

This may be something to consider for those also considering an MBA.  I am not sure if this grant applies to other graduate programs, but it would seam reasonable, especially for other graduate programs such as MPH that Devry offers.  

Blog Schedule

I'll attempt to post more regularly.  You'll see a post from me twice a week.  Most likely on Monday and Thursday.  Subscribe to get an email whenever a new post is up.

Oh, and the app Figure 1 is awesome if you haven't had a chance to check it out.  You can search for most diseases and various pictures that medical professionals post with descriptions about the patient history.  There is a community that comments on the post attempting to come up with the most likely diagnosis based on the symptoms.

Keep Pushing

 All the repeaters are put in a supplemental (ELLS) course.  Today I was asked by my ELLS instructor to shared my experiences with the students who were repeating first semester. I was instantly reminded about the awkwardness of putting on the green scrubs for Anatomy lab a second time around, seeing the same professors and materials, feeling inadequate, but more importantly, I remembered learning how to enjoy the material that I was learning.  Anatomy went from my least favorite to favorite class because I took the time to appreciate the opportunity to dissect and have access to the bodies for most of the day for learning.  I was also reminded of the friendships and study partners developed through the common struggle and the gratification of pushing forward.  Many times set-backs are great because they force us to stop and examine what we have done wrong and what we need to change.  Otherwise, we get comfortable, thinking that our performance is adequate even if we have much room for improvement.  I tried to share what I learned throughout the past year with the students and encouraged them to keep pressing on to the goal... to promote and assist in developing the wellbeing of other people.

First Semester Advice: Time Management

Time management will prove to be very important in med school, as you simply don't have as much time to catch up on material as you did in undergrad.  Any time you fall behind, the amount of work you have to catch up seems to multiply exponentially.  Therefore, you must be careful with how you spend your time.  In the past I sometimes found myself overstating how much time I actually spent studying, so I kept a desktop timer that I paused whenever I browsed something else on facebook (it's easy to waste 15 min. on mindless videos or memes), went to the bathroom, took breaks, etc.  This might be a good thing to implement especially for the first week, just so you have an idea of how long it takes to to create your study products for one lecture, allowing you to schedule more accurately.   I get the best results when I follow a routine of how much time I want to spend making study products for each lecture.  Generally, this is an hour for study notes per lecture.  Sometimes that hour is not enough, but by the end of the day I at least know that I have went through the main concepts for each lecture.  If you don't specify how much time you want to spend on notes for each lecture, then you can easily spend too much time focusing on minuscule details at the expense of learning major concepts from other lectures.  (For our mini exams, there are 2 exam questions from each lecture hour, so study accordingly)  There are usually four classes per day, so four hours devoted for study products.  Then I make a checklist (or in this case use one made by a generous classmate) of what I want to accomplish for that lecture, which may look something like this:

First semester advice: Housing

Most students have likely already picked housing for the upcoming semester, but for those who haven't I'd recommend somewhere close to campus.  I've lived closer to the Annex and right across the street from campus, and living by campus is much more convenient.  Those who live further from campus generally do so because of cheaper housing, especially if you need a bigger apartment for a family, but in my situation the apartment by campus was the same price as my first apartment.  Or they like the idea of not being able to quickly go to campus, forcing them to stay on campus and study.  If you're dissatisfied, you can easily moved next semester, as the leases are just for one semester.  Moving can be a slight hassle, but most taxi services provide services for moving as well, such as Alexis taxi.  I got help from the homie Ryan (I don't have his number on me currently), who's a reliable taxi driver and helped me move late at night.

I currently live at Mac and Judy's.  The landlady is amazing and responds quickly, apartment is big, and it is right across the street from campus.  I pay $650 US monthly.  I would recommend it to anyone.

Before this semester, students weren't having classes in the Annex.  However, this incoming class will have classes in the Annex for this and possibly more semesters.  Therefore, living close to the Annex might prove to be more convenient.  However, you will still have to go to main campus at least a couple times a week or more for anatomy lab, fitness center, subway, clinical activities, etc.