Today was a horrible day

It was the third day of orientation. We were forced to sit in on crappy talks. And the CPSO has screwed up my number. This has huge implications for me and my ability to be able to work. I'm raging.

Rather than drinking myself silly, I made a robot. This robot will protect me from those institutions who try to make me feel powerless. His special antenna are BS detectors. His arms are super fast and adept at punching idiots in the face. He rolls on his feet and all over red tape.

Bleep boop.


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Patient information

During this morning's orientation the privacy guy reiterated that patient information should not be transmitted via Facebook, twitter and blogs.



This makes me want to reiterate that when I talk about patients, if the scenario sounds familiar or that you may know who I am talking about, I assure you that you don't. I change all demographics and actual diseases. As I say on my side bar, all I really care about is how I react to the clinical situation and how others react. I want to learn more about my approach to medicine and hope that I (and possibly you) can learn from these experiences.

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Here's hoping

I dropped off the document missing from my CPSO application that presumably was shuffled in the mail strike. Hopefully things will be put in order for me to start on Monday. Without my number from the CPSO I'm not insured to see patients as a learner.

If it doesn't come in time, I'll be acquainting myself with the family practice clinic and working on my research project. And looking like an idiot who can't do simple things.


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Who?

A weird thing about today - every time they said "ask the residents to ..." or "have the residents..." I kept looking over my shoulder for where the residents were. This is going to take some adjustment.


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Residency orientation

Orientation today wasn't too bad. To me it seemed a lot like my first day of kindergarten. There were big people at the school who were nice to us, gave us apples, peanut butter and bagels. We also got stickers. There were a lot of people who I don't know but who I want to be my friends. We all talked about the things we like to do. I sometimes felt awkward and like I didn't belong. The big teacher told us things that seemed kind and important but she had a whole lot of rules. We had classes and we played together.

Unlike kindergarten, we got to play pretend intubation on neonate dolls, suture on plastic flesh and practice shoulder dystocia moves on plastic pelvises with dolls that did not have nearly enough lubrication.

I think if we got to play with things like that in kindergarten it would have been a heck of a lot more fun.





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aghhhhhhhh!!!

Residency training starts tomorrow with procedural skills.

I don't remember my skills!!
I'm not ready for this!!
What should I wear???

Why hasn't the CPSO sent me my number yet??

Is it OK if I hide under the bed instead of attending?

I'm the only expert about me

(this is the view from my bed - very peaceful - getting up for clinic next week is going to be difficult)

I was thinking this morning about other people's false expectations of me. It happens a lot because I'm older than average and tend to be more confident than the average learner at my stage of training.

Example 1: in first year during an observership I was mistaken for a resident. The nurse quickly told me Dr. Funny Pants was late and I should start clinic without him then left before I could correct her. I had no idea what to do so I sat there like a goof for a few minutes until the clerk showed up and helped me out.

Example 2: First day of clerkship I was on CTU - right up there with general surgery as the rotation most feared by clerks. I had 5 admissions to do while on call that night. The resident we were working with kept getting more and more angry until I yelled "you know this is our very first day right??!!" She didn't.

Introducing myself with my level of training

Disco, savin' lives

We did our ACLS training before our licensing exam. The new guidelines from the American Heart Association emphasize compressions over delivery of air, especially for lay persons.

The hope is that if people have to only focus on one thing - the compressions - they'll be more likely to jump in and help than if they are worried that they will have to do mouth to mouth. And who can blame them. I need a few drinks before I'd consider mouth to mouth on a stranger.

For health care providers, our emphasis is on the compressions too. When in doubt about what to do next in a code, you can't go wrong with compressions.

Ironically, "Another one bites the dust" also has the right rhythm to sing in your head to keep your compression rate perfect.

so many boxes to be unpacked

but look at that well painted wall!!

It's a bit strange being in a city where being a medical student / resident is unusual. People I meet are fascinated and want to know where I went and what's happening next and how it all happened. It's been 4 years since anyone but my family cared.

We are not going to tell out neighbours what I do for as long as possible. We live in a very blue collar area and don't want to stand out. Plus, I'm not sure I'm ready to deal with patio-side consults.

poor kitty hates moving even more than us

she keeps having to find new places to nap - the ones she likes keep disappearing into boxes

while I'm excited to start my residency

and even more so to learn a new hospital, I'd rather be back in the Bahamas than packing my house.

I'm terrible at leaving. It always takes me forever to get out of the house. Packing to move away from my house amplifies my already horrible tenancies.

Something else to work on I guess. But not likely to be corrected before the movers arrive Monday morning.

Definition of Infinity

The apparent time taken for your computer to boot up after receiving the message on your mobile device that the MCCQE results are in.

Pass. YAY!!!!

Advice from those more clever than me about CaRMS

At the end of our third year, we had a panel of residency directors and residents come talk to the class about CaRMS. I feverishly wrote everything down for a friend who was stressed about missing the day. Now that I'm moving, I've just found this again and want to pass it on before I just chuck it in the recycle bin.

This list is not well organized, but there's some good advice in here.

- take care of yourself during the entire process, you'll be less likely to try to jump off your balcony

(our school is one of the lucky ones that doesn't have call during CaRMS!)

- know who you are and what you are great at

- your rank order list is a wish list for your future

- safety first, don't put all your eggs in one basket

- don't rank your back up if you don't want to do it

- things to consider - income, overhead and available jobs at the end of your residency

- what if I have no idea what specialty to pick?

- avoid seduction (e.g. special toys used in the field)

- look at what the day to day life in the specialty is like

- How can I be competitive with a pass/fail system?

- references and their letters

- electives

- research is used as a surrogate for proving that you work hard, focus, problem solve and follow a project to completion

- How do I pick who will do my reference letters?

- someone who knows you really well

-something will something interesting/good to say

- nice to have, but not needed to have qualities of a reference:

- well known

- on the selection committee

- all electives in one area is not a good idea

- diversify

- longer electives --> better reference letters

- high risk/high yield strategy is "bad" (not my word)

- choosing between the programs:

- do their residents pass?

- do they have good employment rates on graduation?

- how happy are the alumni?

- location of the program

- personal factors (family, sports, etc.)

- don't just apply to Toronto

- there are not plenty of spots in the 2nd iteration

- only rank the program if you can see yourself doing it

- just b/c you applied, doesn't mean you need to rank it

- you can apply to as may programs as you want

from the resident:

- personal letter should address:

- why the specialty

- where the program is (I *love* the ocean, etc.)

- some ask specific questions

- pay attention to the word limit ranges

- don't send the wrong letter to the wrong program

- can do generic outline then answer their specific questions

- references:

- most programs ask for 3 - 5

- ask "do you think you'd be willing to write me a good letter of reference?"

- pick someone who knows you well, another who is in your program, and another who isn't from your home school

- as long as you're going to be happy with a back up, go with it

- setting up electives:

- "we're full" isn't always true, use gentle persistance

- 3 week electives are a good amount of time

- don't split your elective time between 2 competitive electives, it makes you look like you don't want either

- when on electives:

- people expect you to be dumb

- be nice and smile

- don't be tired

- be keen but not over the top

- don't be late

- stick around at the end of the day

- offer to do call

- offer to present a case at rounds

- take the time before electives start to get your immunizations up to date

- good general things to have; anesthesia, gen surg, family medicine

- bottom line, residents are chosen based on who they want to work with for the next 5 years

that's it - as I've said, not my advice, it's from people much more clever than me

still not back in medicine mode yet

la la la la la

I've just finished throwing out all my med school notes. Anything I really need I have in the PDF versions, my text books or on uptodate.

When I was putting together my last 2 quilts I kept knocking over my pin tin. Drove me nuts.

Out of necessity I made this pin cushion out of bits of fabric laying around, left over batting from a variety show prop and some lentils to weigh it down. I also got to try out a blanket embroidery stitch.

I'm pretty happy with it. And my vacation. Only another two weeks before I start clinic. I have a feeling I'll be reading about all things family medicine oriented by the end of next week.

more quilting

I'm really loving all the time I have right now to get some of my crafting done. It's awesome.

Who loves a vacation?

Between graduation and the start of residency, we have 5 weeks off to take a vacation, move, file our meds notes in the garbage (and for the true pack rat, our undergrad notes as well) and generally try to get a grip on the new reality that is the MD behind our names.

I know that I've had 4 years to get used to the new letters, but it's still freaking me out. It shouldn't matter, it's not like random people on the street are asking for prescriptions. But people I'm with insist on telling everyone we meet I'm now a doctor. This leads to conversations about heart disease, diabetes, stress and "thyroid".

"I'm thyroid". Really. Not hyper nor hypo thyroid, just thyroid. Got it. That's one for the medical journals.

That's a bit snobbish of me. But it is annoying, especially when I just want to buy milk.

Aside from buying milk, I have been quilting, finishing my MCCQE quilt, making buttons, planning my upcoming wedding and packing. I decided that doing a mad dash around Europe because it "would be my last chance ever" was setting myself up for a load of stress at the beginning of residency. I know that as a practicing doc I'll take the time to travel where I want when I want to rather than cramming it all in. Spending my time on projects that I want to has been rewarding and is making my brain feel squishy and ready to absorb more knowledge again.

But not until July 1st if it's all the same with you.