Becoming a Physician

Scholarship recipients share their experiences as UF medical students


Nearing the finish line

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In a little under two months, my four-year journey through medical school will be over. This last leg of the marathon was by no means smooth, however. You would think I would get used to how hectic and unexpected things can be, but life always has a way of surprising you.

As it turns out, I won’t be going into obstetrics and gynecology just yet. Instead, I am happy to say I am going to be working at UF for another year with the division of internal medicine. While I was disappointed at not being able to go into obstetrics and gynecology the way I wanted to, I am very excited about training with the internists at UF after graduation. I am certain I will learn many new things and have an excellent start to becoming a great doctor while under the guidance of the dedicated staff and faculty here. I’ve learned there are many ways of making your own career in medicine, and I will use this time to work hard, improve myself and do the best I can for my patients.

During these past two months, I finished two of our required fourth-year rotations: anesthesiology and emergency medicine. My time with the anesthesiology team was very educational, and I was able to get a better grasp on how we put patients under and ensure that they are safe while we operate on them. Having been through my general surgery rotation and in other surgical specialties, I had previously only seen what it was like to be on the surgeon’s side of things. But after working on the other side of the curtain, I was able to get a more complete picture of how things work in the operating room. Before starting the rotation, I had already known there would be much more to anesthesia than just putting patients to sleep and watching their vital signs. After finishing the rotation, I had a better appreciation of just how complex their jobs are.

Anesthesiologists are the experts in preparation and vigilance. They leave nothing to chance and always have a backup plan in case something goes wrong. Their job starts well before the surgery begins and does not end until well after the patient is awake. It is up to them to determine: how best to position the patient before surgery, what paralytic and induction agents to use, intubating the patient, determine what kind of ventilator settings to use once they’re intubated, what fluids to give and when, what medications to give and when, monitor the vitals and breathing, watch out for side effects of medications, keep in mind the timing of when they need the anesthesia to wear off, extubating the patient and controlling post-operative pain and nausea. In addition to all of that, they have to chart when they did each of these things during surgery. It’s easy to get side-tracked, and I was impressed by how well the residents and nurse anesthetists fielded all of the interruptions and unexpected demands they came across. As for myself, I was able to learn how to mask ventilate patients, intubate them, prepare medications and help in any other capacity that I could. In fact, I did those things so often that one night I even had a dream that I was mask ventilating myself! Overall, it was a very worthwhile experience.

Emergency medicine was a rotation I was very much looking forward to. I had previously worked in the emergency room on some occasions, like seeing consults as part of a different hospital team or working for a week in the pediatric ER as part of my pediatrics rotation. From my prior experiences, the ER is a busy place where a lot of important medicine happens. There are patients who present for all kinds of issues, from specific complaints that have a known origin, to more vague complaints that could have a wide variety of causes and must be worked up extensively. The ER does not turn anyone away, and its main goal is to rule out and treat any conditions that are life-threatening. As part of the team, I spent four weeks working in shifts that occurred throughout the day, in both the adult and pediatric emergency rooms.

Perhaps the most striking aspect of emergency medicine is the variety of cases that can walk in at any time. Inside of one eight-hour shift, I could see patients with: chest pain, a strange rash, a scalp laceration, eye pain and patients brought in from various traumas. The trauma patients were the ones who left the deepest impressions. There were cases we saw of severe burns, car accidents and gunshot wounds that were all so intense to be a part of. It was amazing to see just how well the ER team worked together to stabilize the patient. It was like watching clockwork, the way each person knew what they were doing; whether it was doing chest compressions, getting IV access, intubating the patient, performing an ultrasound, making notes on the timing of the drugs we administered or charging the defibrillator for when we needed it. Sometimes the patients did well, and sometimes they did not. But as urgent and scary as the situations were, there was always a sense of calm and purpose in the trauma bay, which is exactly where it is needed the most.

My favorite part of being in the emergency room was the fact that I was able to walk back into my patients’ rooms and talk to them while we were waiting for a test to be done or for an inpatient hospital bed to open up. Sometimes all of that waiting can be anxiety-provoking, so I would try to interact with my patients as much as I could. There are very interesting people who come to the ER, each with their own stories and backgrounds. Oftentimes the patients were accompanied by their family members, and I was able to get to know a lot of people. We talked about anything that came up: jobs, traveling, what was on the television. But my favorite part of talking to them was the fact that I was able to keep them up to date on what was going on, what our plan was, and answering any questions they had. They were very appreciative of the time I spent with them, and it reminded me of why I decided to go into medicine in the first place.

At the time, I was still sad about not being able to go into obstetrics and gynecology next year, but I realized that as long as I have the opportunity to continue taking care of people, I would still truly be happy. From my experiences these past two months, I’ve learned that changes can occur when you least expect them. But as long as you don’t lose sight of your purpose, things will have a way of working out.

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My month with the dermatology team

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I have spent the last four weeks staring at people’s skin — with their permission, of course. I have been working with the Dermatology team at UF, and it has been an eye-opening experience. The skin is such an interesting organ; everyone has it and there are so many different shades, quirks and curiosities you can find with it. You can tell if someone’s spent a lot of time in the sun, if they work a lot with their hands and what kind of accidents and surgeries they might have been through. It can be an indicator, not just of how well you appear on the outside, but also if there might be something going on inside your body. Because of how versatile and interesting skin is, I decided that rotating with the Dermatology team would be worthwhile. At the very least, I could develop the skill of identifying and naming lesions on the people I meet, which will hopefully make me popular at parties.

The dermatologists at UF are all very nice and friendly people. They are very intelligent, and all of them seem to have perfect skin themselves. I don’t think it’s one of the requirements to be a dermatologist, but it certainly can’t hurt. Each of them would also make for excellent detectives. The interesting thing about dermatology is that a lot of lesions and rashes can look similar, and it takes a lot of thinking to figure out what’s really going on. Bumps and rashes can change appearance over time, go to different places on the body, and do different things. It also depends on how old they are and if a patient has put something on them or scratched at them, so there can be two or even three different things going on in just one skin finding, and it’s up to the dermatologists to sort all of that out.

It’s amazing to see them at work and watch how they come to their conclusions. I remember one patient who had a rash on her abdomen and the right side of her face, which was a very strange distribution for a rash. After asking some questions, the doctor was fairly certain that the patient had a contact allergy, likely to nickel from a metal belt buckle that she usually wore. As for her face, the doctor asked if she played any sports that required her to wear a helmet, recently changed her pillowcase or face wash, and other questions he could think of. Eventually, he figured out that her cellphone had a metal case that she would rest against the right side of her face whenever she talked on the phone, and that was exactly where the rash was. It was very impressive to witness, and the kind of thing you would expect to hear in a Sherlock Holmes story. It’s funny how everything is revealed in the skin, right in plain sight, but it takes a lot of effort and experience to unravel what is going on.

As for myself, I started out learning all of the common things that appear on patients. There are a lot of ordinary things that you often see people walking around with, like: seborrheic keratoses, skin tags, eczema, warts, solar lentigos, acne and cherry angiomas, all of which are not worrisome. While other things like: drug rashes, actinic keratoses, squamous cell carcinomas, basal cell carcinomas and pigmented lesions suspicious for melanoma require caution and treatment. I’ve also seen conditions like: psoriasis, rosacea, vitiligo, lupus and mycosis fungoides, which many people have heard about but may or may not have seen. It amazes me to see the kinds of things that can happen with skin, and I’m grateful that I don’t have too much going on with my own.

Sometimes if we encounter a lesion that we can’t immediately figure out, we biopsy it to see what it looks like under the microscope. Sometimes we shave the lesion off, and sometimes we punch it out with a tool that acts like a cookie cutter. I’ve been fortunate enough to get experience doing lots of both. It’s a peculiar thing to do, cutting out a piece of someone’s skin, and perhaps even more peculiar to be on the receiving end of it. I had a shave biopsy performed on myself a few years ago, which was actually done by one of the attending physicians I ended up working with this month, and it was a very odd experience.

I had a rash on the back of my left hand for a few weeks that was very itchy and was taking a long time to go away, so I went to see the dermatologist to figure out what it was. The dermatologist looked at my hand, poked it and pushed on it, and wrestled my arm to bring my hand closer to her face to get a better look.

“Hmmm… I don’t know what this is,” she said. “Let’s biopsy it!”

And before I knew it, she was setting up the instrument tray and the nurse came in the room with a camera to take a picture of my hand for the records. I was a little surprised, as I wasn’t quite expecting a biopsy so suddenly. But I wanted to get to the bottom of what was going on, and it felt like the right thing to do. After numbing the area, the doctor took out a tiny saw with plastic edges that she held between her index finger and thumb, and shaved off a piece of the rash. The saw reminded me of the saws that you see pairs of cartoon lumberjacks using to cut down trees, only hers didn’t have any teeth. Afterward, they put a Band-Aid on it and sent me home. A week later, I got the results and it turned out to be spongiotic dermatitis, which is a characteristic of eczema. They gave me some steroid cream to use on it and it went away, and hasn’t bothered me since. Though, I do still have a pigmented scar on my hand as a reminder of the experience.

And now being the one to do the biopsies feels like completing some kind of circle. I feel more comfortable doing them, as I’ve gone through the experience myself. It’s very humbling too, as your skin is the most obvious part about you, and trusting someone enough to perform a procedure on it is very significant. I have learned so much from this rotation, and I believe that what I’ve learned this month will definitely help me in my future practice.

The only other significant event that occurred this month was that I finally finished the last of my residency interviews. I am very happy with how my interviews turned out and can see myself training at every place I visited. After going over all of my programs with my adviser, I ranked them all in a list and submitted it to the National Resident Matching Program. In March, a computer algorithm will take all of the applicant lists and residency program lists and try to make as many suitable matches as possible. Much like with a skin biopsy, the only thing left to do now is to wait for those results.

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The interview trail — with a surprise ending

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Collage #2

From coast to coast and north to south, I racked up quite a few frequent-flyer miles and put some extra miles on my car during the interview season. Two months of packing and unpacking suitcases gets old fast, along with nonstop traveling, but overall it was fun going to different places. On the journey, I ran into some of my UF classmates on a few interviews — and, even more surprising — I ran into a couple of my old MIT classmates, including one who is a current IM resident and another who was on the interview trail like me. “It’s a small world after all!”

I am fortunate enough not to have any interview horror stories about lost luggage or getting stuck in a snow apocalypse. However, I did have a handful of delayed flights that reduced my sleeping time between interviews on a couple of occasions, which can be a pretty big deal since some interview days run until 4 p.m. and dozing off won’t help you earn a high spot on anyone’s rank list.

But overall it was an awesome experience traveling all over the country and seeing the different hospitals and meeting other medical students. I also enjoyed doing a lot of touristy things in the cities I could afford to stay multiple nights in because I stayed with family or college friends. Now it is time for me to evaluate all of the programs I visited and make my rank list based on where I feel I can get the best residency training. I hope my classmates had a great interview season like I did, and I can’t wait to see where we all end up on Match Day (March 20).

Last, but certainly not least, I made a pit stop in Boston with my boyfriend who I met while studying at MIT, and in that very city where we first laid eyes on one another he asked me to be his wife! Best ending to interview season EVER!

Collage 1

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The End of 2014

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This 2014 holiday season has been the last that I’ll have as a student with free time, and I’ve had a chance to relax before the New Year and my last semester of medical school. It does feel strange writing that down and knowing that graduation is just around the corner. Time has gone by so quickly, and I now understand what many doctors meant when they said that in medical school “the days are long but the years are short.” “It’s the same way in residency too,” they also told me, and I feel as though I will be realizing the meaning of those words again very soon.

I feel like my life has changed a lot over this year. Of course, every year of our lives is significant in one way or another, and it’s always good to think about what kinds of changes have taken place. Hopefully, many of those were positive ones. 2014 has successfully seen me through the end of my third year of school and the beginning of my fourth, past my second series of board exams, and into the midst of my residency interviews. Many things have been accomplished and many things are still underway. I remember enduring many long working days, talking with many interesting patients and working alongside many intelligent and witty students and doctors. I have grown a lot as a person and have a better idea of what I want my life as a doctor to be like and the kind of doctor I want to be. I’m happy to say that, if I could do the year over again, I wouldn’t do anything differently. I am happy with everything that went well, and I’ve learned not to regret the things that went wrong.

Though my life has changed much over the course of this year, there will definitely be many more changes in the next. Some of the changes are expected, like graduation and the residency match, while others will be unforeseen and unpredictable. I hope I am ready to meet those unexpected challenges when they come. Thinking about it, I used to be in such a hurry to get to this point in time. And now that I am here, I find myself wishing that these long days could be a little longer. It makes me wonder why I think that way; perhaps I am too happy with the present, or cautious about the future, or both. But if there is one thing we cannot control, it is time. It moves on, always to new and unfamiliar territory, but somehow seems to have a comforting way of repeating itself. No matter what happens, it feels like 2015 will be a very interesting year.

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Interview season

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Over the past few weeks, I have done more traveling than I can ever remember doing in one period of time. I’ve been to places all over the Southeast, traveling to interesting states like Tennessee, Texas, Mississippi and Virginia. Sadly, this has not been for vacation, but for interview season.

At this time of year, fourth-year medical students across America are flying around the United States, looking at programs to train with for our residencies. I’ve stayed at each place for no more than a couple of days at a time and have grown accustomed to waiting in airports, running around those same airports to catch connecting flights, driving rental cars and getting lost in unfamiliar cities, and staying in a string of different but similar-looking hotel rooms. It is both a stressful and exciting time of year, and quite unlike anything I’ve experienced in medical school so far.

Working through the residency application process was fairly smooth. Once I submitted my online application and applied to the programs I liked, the most difficult part was the waiting. There was a lot of waiting to see if all of the paperwork, test score, and letters of recommendation were sent, and then more waiting to hear from programs to see if they wanted an interview.

For the last two weeks of September and the first few weeks of October, I was constantly checking my email for messages and frantically typing responses to programs whenever I received an invitation from them. Every time my phone buzzed with a new email, I would jump up and my heart would skip a beat. Needless to say, it was a very strange time to be working around me, as it must have looked like I was getting shocked by an invisible force at random intervals.

The residents and attendings I was working with, however, knew exactly what was going on. They took the time to reflect on their own experiences with interviews and gave me advice on how to get the most out of them. The most common thing they told me was to just be myself, as the interview process is less about determining the clinical competence or intelligence of an applicant and more about determining compatibility and personality. Program directors want to see if you fit in well with their institution and program philosophy, and if you could potentially grow with the program and get along with the other team members you would be working with.

Likewise, it is also a time for you to figure out if you can see yourself working in that program’s environment, and if you have the same priorities and goals that they do. They also told me that, above all else, you should trust your instincts and pay more attention to how a program makes you feel rather than other aspects, such as what their case numbers are or what their facilities are like. With all this in mind I felt more prepared, though no less anxious, to start my interviews.

Once the interview dates became more or less solidified, it was exciting to look at my list of programs and see all the potential places I could end up working in. I was very happy to see how my list was shaping up, and the next step was to coordinate the transportation and lodgings. I had to see if I wanted to fly or drive to a particular interview, if I had to rent a car and where the hotel nearest to the institution was.A lot of this was new to me, and it was great to learn how to manage the logistics of traveling and making sure all the necessary arrangements were in order.

So far things have been working out well, and I have actually learned a lot about the geography of the Southeast. This is a good thing, as I’ve never been very good at knowing where exactly all the states were located and what the major cities were. Every interview is a new adventure, and it has been very interesting to meet new people and see how other programs approach practicing medicine.

One of my favorite parts of each interview has been the resident dinner that is usually held the night before the interview. It is a great time to meet the residents of the program and talk to them about what it’s like to work and live in that city, as well as the kinds of things they do for fun. It’s also a great opportunity for them to meet the applicants and see who they might be working with next year.

Each dinner has been very informative and a great way to relax and alleviate anxiety before the official interviews, and I’ve found that each program has its own flavor and style. It’s difficult to put a finger on exactly what it is, but I am now appreciating more and more the advice I was given to just go with your gut and remember how a program makes you feel.

So far, I’ve had a lot of positive experiences with the residents I’ve talked to, and they have all seemed very happy with their choice of residency. It reassured me that the whole interview and matching process was designed to yield the best and fairest results for both the applicants and the programs. The residents were always willing to talk about the positive and negative aspects of their program, what their daily life is like, how they get along with their co-worker, and their own career goals; all of which was very valuable information to keep in mind.

The interview days themselves have been, just as I was told, very relaxed and enjoyable. Aside from the interviews themselves, the day usually consists of meeting the staff and faculty of the program, listening to a talk about the program itself and what life is like in that city, and then going on a tour of the facilities and meeting the residents.

The interview formats themselves have varied a lot depending on the program. Some interviews last more than half an hour each, while others are around fifteen minutes. Sometimes the interviews are done one-on-one, and other times with groups of people interviewing you. They usually include the program directors, faculty members and residents.

Regardless of the format or timing, they have always been very laid back and even enjoyable. Many interviewers are genuinely interested in you and your hobbies and talents, and ask questions to get to know you better as a person. I have talked to interviewers about so many different topics, many of them not related to medicine at all. I have talked about traveling, languages, my favorite foods, books, and movies, and my hobbies, like writing for this blog. I’ve also talked about my experiences as a medical student at UF, and was pleasantly surprised to learn that many of my interviewers were familiar with some of our faculty members and the work they did. It made me very proud to come from an institution with such an outstanding reputation.

Another great thing about going on interviews is that you get to meet other medical students from all over the United States who are going through the same process as you. At first, I thought it would be an intimidating thing, as all of us are essentially competing for the same limited spots in training programs, but it has been the exact opposite. I have enjoyed talking and interacting with the other applicants very much, and they have all been very friendly and interesting people, each with unique backgrounds. I have even bumped into some of the same people in later interviews, and it is always great to catch up and see where they are in their interview trail.

Seeing my fellow medical students and getting to know them reminded me of how large the scale of medicine is, and that everyone is on their own journey of trying to find where they would be happiest. As of now, I am only about halfway finished with my list of programs to visit, and I am very much looking forward to seeing how the rest of the season develops.

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More rotations and the upcoming interview season

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We survived the night shift! Me and Amy Sheer, MS4

We survived the night shift! Me and Amy Sheer, MS4

Since my last post, I have been busy cultivating my skills in the area of cardiology on the inpatient consultation service at UF Health Shands Hospital. During the few weeks I spent on this team, I read numerous EKGs daily and markedly improved my EKG interpretation skills along with learning some tips for working up cardiac complaints. Having proficiency in both of these areas will help me tremendously as an intern next year.

Following my time on the cardiology service, I had the pleasure of working at Brooks Rehabilitation in Jacksonville. While there, I was able to work with an awesome team of physicians and physical and occupational therapists to help improve mobility and function of several patients who have experienced traumatic and non-traumatic spinal cord injuries. Day after day I worked with patients before and after they went through hours of therapy with the goal of getting themselves into the best shape to leave the facility as independent as possible. I enjoyed my conversations with many of the people there; to hear their stories and see them have such a positive outlook on life was very humbling.

In my last post I spoke about my decision to pursue internal medicine as my specialty of choice, and shortly after I submitted my residency application. Since that time I have been very fortunate to receive interview invitations from several residency programs. I will admit I was a bit nervous about hearing back from programs, so when I received my first interview invite, I was overcome with joy and hope. I knew I was one step closer to my goal of becoming a licensed and board certified physician.

Over the course of the next few months I will be interviewing at these places to get a better understanding of the type of learning environment and overall experience I can expect during residency. I feel blessed to have this opportunity and plan to evaluate all my options carefully, with the goal of choosing an institution that will nurture my career interests and provide me with the necessary experiences to be an excellent physician.

All the while, I have been continuing my rotations and recently started one in emergency medicine in Jacksonville. I began with the night shift — or, as my dad so aptly calls it, the “graveyard shift.” It has been a big adjustment for my circadian rhythm, but I have enjoyed the fast pace and different approach to problem solving. I am sure I will see plenty of interesting cases before this month is over, as UF Health Jacksonville is a Level 1 Trauma Center in a pretty large and diverse city. But I am up for the challenge, and I think I will learn some valuable skills that will come in handy during residency.

Next up: Three more weeks of emergency medicine and the start of interview season. Fourth year is turning out to be as fun and exciting as previously advertised.



The ingredients of life: My month with the REI team

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Over the past month I’ve been working with the Reproductive Endocrinology and Infertility team here at UF, and it has been an eye-opening experience. REI is a specialty within Obstetrics and Gynecology, and I spent four full weeks working with the faculty in their clinics and in the main hospital. I hadn’t had much exposure to REI before going on this rotation. I knew a little bit about in vitro fertilization and the different medications we give to women to increase their chances of pregnancy but did not know much about how it worked practically. I was eager to learn as much as I could about it and signed up to be part of the team as soon as I learned it was an available rotation for us. Starting from my first day, I was able to dive right into it.

I got to the clinic early and was told to change out of my formal clothes and into some scrubs, as the attending physician and REI staff were going to do an egg retrieval on a patient before clinic started. I changed and quickly met everyone in the procedure room. Everything was all set up and the doctor was using an ultrasound probe to look at the patient’s uterus and ovaries. I was amazed to see that each ovary looked to be the size of an orange! The medications the doctors had given the patient had made her produce many ovarian follicles, which each housed a single egg. So instead of preparing one egg each cycle as a woman normally does, the patient had prepared many; this gave the team the best chance of being able to fertilize each of the eggs and turn them into embryos. It was amazing to watch the attending use a needle to vacuum up the follicles into some test tubes, which were all handed to the embryologist for inspection and processing. All in all, we collected from more than 20 follicles and were optimistic about our chances.

It amazed me that, as we went on with morning clinic, seeing patients and dictating notes, those eggs we collected were changing and growing with each passing moment. In one of the clinic rooms I saw a large poster with diagrams of the different stages of growth, from embryo to fetus to newborn. And as I looked at it, I thought it was amazing time to be alive. We have the ability to see and know how a person grows, even from the point where it is nothing more than a collection of cells. Everyone who is alive today made that journey described on the poster, and seeing it made me remember just how connected we all are.

That feeling of amazement never went away as the rotation continued. From early on, I could tell that all the doctors and clinic staff had that same sense of appreciation. One of the attendings, Dr. Christman, is incredibly enthusiastic about the whole field of reproductive medicine, having been involved in it since its very beginnings. I was with him one day as he was talking to a couple about potentially starting in vitro fertilization for them. He talked about how his job never gets old and how he still finds it exciting, even after practicing for decades. He said, “Sometimes we help patients have a child and then they come back a few years later for us to help them again. They’ll bring in their 2-year-old and you look at the kid and say ‘Wow, it’s been almost three years now but I still remember walking by your storage tank when you were just a frozen embryo!’” I could tell that he never stopped appreciating just how incredible his job was.

One of the other attendings, Dr. Rhoton, also shares Dr. Christman’s enthusiasm. She told me that she couldn’t possibly imagine doing anything other than REI. “I go into work every day doing what I love,” she said. While working with her in clinic, I could see just how much she cares about her patients. She is very supportive and always encourages them to “think baby thoughts!” whenever it comes time to transfer embryos or do fertilizations.

I was also touched by how committed the REI staff was. They worked tirelessly to make sure the patients were prepared for undertaking the long and stressful journey that was an infertility treatment. Though we have many options to help our patients, sometimes it takes a long time and many cycles to achieve a pregnancy, and it can be emotionally taxing for everyone involved when things don’t work out. To this end, the clinic staff were some of the most compassionate and supportive people I have ever worked with. They made sure the patients were well-informed and had all their questions answered and anxieties addressed, and even stayed behind after clinic to help them with whatever else they needed.

Overall, I had a wonderful time in REI and learned a lot about how to take care of patients who need extra help getting pregnant. And our clinic did not just help patients with fertility issues; we treated patients with a variety of other endocrine needs as well. I have heard so many unique and memorable stories from the patients I talked to. I am very thankful for the experience and am that much more certain I am going into a field that I will thoroughly enjoy.



Fourth year is here!

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My classmate, Brittney Newby; myself; and my sister, Ashley Simmons at the Beyonce and Jay-Z concert during the On the Run tour.

My classmate, Brittney Newby; me; and my sister, Ashley Simmons, at the Beyonce and Jay-Z On the Run concert.

It is hard to believe I am eight months away from graduating medical school; it seems like only yesterday I was at orientation.

To begin my fourth year I traveled to  NYC for some shopping and good food and saw the Broadway play “Wicked.” I had an amazing time. Then I went home to visit my family, and while there, I attended the “On the Run” tour concert in Miami with my sister and classmate. After that I returned to Gainesville for the rest of my study month to prepare for the step 2CK and step 2CS examinations before I started clinical rotations.

Currently, my classmates and I are in the midst of putting together our residency applications, which include personal statements, requesting recommendation letters and writing all about the various activities we have done over the last few years.

I have decided on internal medicine (IM) as my specialty choice because of the complex problem solving and patient relationships you can develop on the wards or in an outpatient setting. Another aspect of IM that I find appealing is the large number of career opportunities available after residency such as hospitalist, primary care or procedural specialties like cardiology.

I am currently in the last week of my sub-internship rotation in internal medicine at the VA hospital. During these few weeks I have had the opportunity to act as an intern (the role of a first-year resident) and experience a few lab simulations to get some experience with code situations. It was a tough adjustment at first since I had not been on medicine wards in more than a year, but my attending and residents were very supportive and helped me get up to speed rather quickly.

And I’ve been running full steam ahead ever since! Last weekend I had the opportunity to work a few night shifts with night interns, which I thought was good insight into what I can expect next year as a resident during the few months I work at night.

Next month I start my combined Anesthesiology and Intensive Care Unit rotation along with submitting my ERAS application for residency. It should be a busy yet exciting month!

The Green Team selfie! First row: PGY1 Danielle McLaughlin Cobb; PGY1 Sarah Truelson; and PGY1 Sebastian Puig. Second row: MS3 Justin Dersch; me; PGY2 Carlos Leon. Third row: MS3 Cheri Mostisser and PAS2 Chris Pratt. Back row: PGY1 Joe Legacy and Dr. Hollander.

The Green Medicine Team selfie! First row: PGY1 Danielle McLaughlin Cobb; PGY1 Sarah Truelson; and PGY1 Sebastian Puig. Second row: MS3 Justin Dersch; me; PGY2 Carlos Leon. Third row: MS3 Cheri Mostisser and PAS2 Chris Pratt. Back row: PGY1 Joe Legacy and Dr. Hollander.



On being a student and a teacher

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A few weeks ago, I finished taking the second series of my board exams, called the Step 2 exams. I spent the better part of a month studying for them, and every day I learned something new and learned again some old things I had forgotten.

While studying in the library one day, I ran into one of the senior residents I had worked with during my surgery rotation. It turns out he was there to study for exams of his own, and to work on a lecture he was going to present soon. “The studying never ends,” he told me, and said that the life we chose is one of constant learning and re-learning. “You can’t get away from it.”

But that is by no means a bad thing. It keeps your mind sharp, and I like the idea of seeing things again and again, and the safety that comes with repetition. There is nothing like rediscovering a topic you thought you had known about before and finding a new twist or facet to it. It’s refreshing, like waking up somewhere cozy and familiar after taking a long nap.

What I’m discovering more and more as I progress through my fourth year are new responsibilities. I am currently taking my Maternal-Fetal Medicine elective and often work alongside the third-year medical students and second-year physician assistant students. Looking back on my own experiences in my third year, I remembered how helpful and kind the fourth-year medical students were to me, and now that I was in their shoes, I wanted to make sure I continued that tradition.

At first I was a little nervous about answering their questions, as I did not want to accidentally tell them the wrong things. But eventually that nervousness went away, and I found that I did have a lot of useful things to teach them. I answered as many of their questions as I could and taught them basic things like: how to interpret fetal heart tracings, how to tie surgical knots and the different screening tests we use. There were even things they asked about that I did not even realize I remembered, like the different maneuvers you could perform during delivery and specific drugs you should and shouldn’t use during pregnancy.

And, of course, they taught me many new things as well. It’s interesting, being both a student and now a teacher of sorts. I find myself studying now not just for myself, but to make sure I can share my knowledge with others if they ask for it.

The only other major event in fourth year so far has been applying to residency programs and preparing for interviews. It is stressful and anxiety-provoking, and I will be happier when it is over. However, I have had a lot of help and guidance from the faculty members here, and they have made me feel much more relieved about the whole process.

It’s funny how there will always be something that stresses you out in life; I felt the same way about my Step 2 exams a month ago, and now being on the other side of them, it seems odd that I worried so much. Also, the residents here are always happy to give interview advice and tips on how to prepare and what to expect. And by this time next year, I’ll be in their shoes, giving advice to fourth-year students myself.

It is an honor indeed to be part of this tradition. As I move forward with my education and career, I hope I will always have something new to learn, and something new to teach.

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An end and a beginning

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Third-year medical student Girard Cua interacts with a therapy horse during his geriatrics rotation.

Third-year medical student Girard Cua interacts with a therapy horse during his geriatrics rotation.

The transition from our third year to fourth year was very swift. One week I was finishing my Internal Medicine rotation — the last rotation of third year — and the very next Monday I was starting Geriatrics, the first rotation of fourth year. I didn’t feel any different, though I did feel somewhat smarter than I was last year. I suppose knowing that is good enough, though I still would have liked something more visible to mark the passage of time —something like a pin or a T-shirt that reads, “I survived my third year of medical school” would have been nice. If that were on a T-shirt, I would wear it for the rest of the summer.

In the closing months of third year, I had my Pediatrics rotation. As is the custom during Pediatrics, I started the rotation on a Monday and was sick by that Thursday. But other than that, I very much enjoyed working with the patients as well as their parents. On the inpatient service, I got to see a lot of conditions that are usually only seen in children, and the medicine would have been interesting if it were not for the fact that it involved kids being sick. If it were up to me, children would never get sick and would be outdoors playing all day, not inside a hospital feeling miserable. That is mostly why I can’t see myself doing Pediatrics.

It was especially distressing working in the Pediatric Emergency Room. Kids are getting into so many accidents these days; during my week there I did a lot of suturing of lacerations on hands and feet, and saw a lot of things being removed from places they shouldn’t have been in the first place, like a twig that got stuck in a kid’s nose. I can’t remember ever getting into that much trouble when I was little; I’ve never broken a bone or anything, and I still don’t intend to. But it was great being able to work with the pediatricians, as they are one of the best when it comes to bedside manner and patient care, and are some of the most sincere people I have ever met.

My rotation in Geriatrics was a lot of fun. I spent two weeks at a rehabilitation hospital and learned so much about rehabilitation medicine, especially how the physical therapists, occupational therapists, speech therapists and nutritionists work together with the physician and nursing staff to give recovering patients the best care possible. It was very rewarding to be able to work with the patients there, as they had so much energy and were so positive and optimistic. It was great being able to watch them in therapy and see them improve day by day.

What I really liked was how the hospital focused on the emotional and social well-being of the patients in addition to just the medical and physical aspects of the rehabilitation. I was very happy to learn that they used animal therapy for the residents. While working in the main hospital, I had seen volunteers bring in therapy dogs, who brought so much joy and comfort to the patients with just their presence and companionship; that is something that no human words can ever match. At the rehabilitation hospital, they brought in miniature horses for the patients, which were amazing creatures and really showed how much the hospital cared about the emotional well-being of their patients. The patients petted the horses, took pictures and even walked around the courtyard with them. I felt very lucky to meet one up close. It made me forget about all of the important and anxiety-provoking decisions that needed to be made very soon.

Right around this time of year is the time for our class to start looking for residency programs to apply to. All of us have decided what fields we want to pursue and are now making more serious strides to accomplish our goal of matching into those specialties.

As for myself, I have decided to go into Obstetrics and Gynecology. Of all of my rotations in third year, I enjoyed Ob/Gyn the most and can honestly see myself practicing it in the future. As I mentioned before, I think that Obstetrics is a very exciting field, especially Maternal Fetal Medicine, and there is so much good medicine and biology involved in taking care of patients as they progress though their pregnancy. It is also one of the most human and humbling fields that I have seen so far because of its social and emotional aspects and the fact that pregnancy is such a life-changing thing that affects people in so many unexpected ways.

And though I can’t imagine having children of my own, I still get irrationally happy every time I see a baby being delivered and the expression on the parents’ faces as their baby is presented to them. There is something about it that I do not think will ever get old.

But there is still a lot of time left between now and the future, and still a lot of work to be done.