Incompetance- my own this time.

So it's been over a month since I last posted. Mainly that's because nothing of note has happened in the last month and I haven't really felt compelled to write. I did very well in GI which was surprising considering that I didn't think I had studied very hard. The skin, bone, and joint module (SBJ) has been underwhelming. It's a random hodgepodge of stuff, including geriatrics, and the material itself is not interesting. I have now ruled out oncology as well as dermatology as career options. Derm is ultra-competitive anyway, but I'm glad to know that I really have no desire to analyze skin lesions that all look the same. It seems that the derm faculty here recruits solely 28 year old tall thin women, since we have had 5/7 lectures from that kind of professor. Perhaps recruit is the wrong word. I think they all rush the derm department in the same way they rushed their sororities.

I have started studying for the boards, and it's not going very well. There's a lot of material that I have forgotten, or never really knew in teh first place. Biochem is the case in point. Looking at the Krebs cycle, it's as though I never knew it; likewise with the regulation of gluconeogenesis. This is particularly frustrating stuff to memorize because I know that it's just going to leave my brain again in two months anyway. I really don't enjoy cramming stuff that i'm going to forget anyway, because ultimately, I didn't really learn it, so what's the point? Well, right now, the point is that I need to do well on the boards before I can shuffle the urea cycle back to the dusty attic where I semi-remember metabolic pathways.

So I had my first patient enounter as a medical student in my capacity as a student, not a volunteer at the student clinic. I was paired with my classmate and assigned to get a history from an elderly nursing home resident. I sucked. It's pretty hard to take a history from someone whom you can't understand, and for whom life is as ok as it's going to get in a long term care facility. No chief complaint = hard to pursue line of questions. There was no logic, no flow, no sequence to my questions. My presenation of the patient to the attending also sucked. Since I've never really been taught how to verbally present a patient, this is to be expected. I also realized that I have forgotten what little I knew about physical exam. I realize that 20 minutes sessions with a standardized patient learning skills was really not enough. I would much preferred to have had a doctor there, with me and the standardized patient to show me how these things are done, rather than having a glorified layman actor teach me how to examine a patient. Where does my $44K go anyway?

Overall, it's been a pretty sucky 3 weeks in this unit so far. At least I have my back pain to keep me pre-occupied.