"Of course you can ask me that, you are my almost doctor person!"

I just finished my third week on outpatient medicine in Seattle. It has been so much fun, but I have been really busy (that is why I haven't posted as much recently). For outpatient medicine I am with a really nice girl named Ana that I actually know fairly well from my anatomy group. She is very smart and organized and is also very helpful and kind to every one around her - in short, a perfect person to have a rotation with. Our first day of the rotation was spent trying to get an ID badge - would you believe it took us 6 hours? I was joking that the id badges are so precious and take so long to get that if you got mugged on the way home from clinic you would probably say, "Take whatever you want, just PLEASE let me keep my hospital ID badge!" Maybe a little bit of an exaggeration, but not by much. :)

As far as what we do in the hospital on our outpatient rotation, we go from seeing patients in the primary care clinic to seeing patients in the ER (the medical side, not the surgery side), to observing physicians in the hematology/oncology clinic, to seeing patients in the renal clinic, etc. Some of the other really helpful clinics we observe/see patients in are the endocrine clinic, the movement disorder clinic (aka neurology), and the musculoskeletal rehab clinic. When we see our patients the sequence sort-of goes like this: We quickly review the chart and or the complaint that the patient is coming into address. Then our attending physician/teaching fellow introduces us to the patient and says, "Christine is a third year medical student and she is going to take a history on you and do a physical exam. Then she will present your case to me and we will come up with plan together." So you chat with the patient and collect the history of why they came into the hospital. Then you perform a focused physical exam - as pertains to the thing(s) the patient is complaining about. Then you take a few moments to collect your thoughts and present in about 3-5 minutes what the patient just spent a considerable amount of time collecting from the patient. At the end you tell your preceptor what you think the differential diagnosis is and what you plan for management is (this is the part that I am by far the weakest on right now). Then your preceptor/attending physician tells you all the things you missed or should have thought about and tells you the parts of your plan that are good or need improvement/more thought. You go back in with your attending physician and he/she checks some of your physical exam findings and asks a few questions and lets you present the plan to the patient. Then you or the attending put orders (such as tests, labs, etc) or consults into the computer which have to be signed by your attending doctor. Then you write up a "note" about the encounter including the history you took, the physical exam findings, and your assessment and plan. This may take 20minutes - a couple hours depending on how complicated things are and how clear your thought process is. Then the note goes to your attending physician who has to read it and sign it (and/or make corrections) before the note is finally part of the patient's file. Then sometimes you get to call the patient later on with the results of lab tests, etc. All-in-all, it is really interesting and a lot of fun. I learn so much everyday!!!

This last week I had patients that I got to see twice (so some continuity) it was nice to see how things were going with the medications that my preceptor and I suggested. It is also nice to get a taste of what it would be like if you were seeing the same patients over and over again if you were a real doctor. Last week I needed to ask some sensitive questions to a patient that I was seeing for the second time. I asked him if it was ok if I asked these questions and he responded with a huge smile and said, "Of course you can ask me that, you are my almost doctor person!" I is so amazing to me that someone considers me to be their "almost doctor." Wow, 3rd year is awesome! It is challenging, but by far, 10 times better than first and second year.

I will try to give up dates and stories as time and medical privacy laws allow.

I passed!!!!! board studying craziness

I just found out that I PASSED the USMLE step 1!!!!!! I took some pictures for this blog post before I found out my score, but I thought it might be sort-of depressing if I told you all about how much I had studied for Step 1, and it turned out that I had actually failed. I was a little bit disappointed in my score (I was secretly hoping to do better), but I passed which is what really matters!

My technique to studying is that if you are producing something or actively engaged somehow, it helps you learn so much better. I dedicated myself to taking volumes of notes from various sources and making study sheets which I plastered all over our house (I think my roommates are glad that I am done with Step 1 too). :)


This is my freak-out picture. I tried to capture some of my inner feelings about the whole studying for boards thing. The First Aid Step 1 book is sort-of the bread and butter of board studying and I supplemented it a lot with listening to some board review audio lectures, going through cases and practices questions and some other subject based board review books. All in all I think that I probably bought/tried to use too many books, but I think it is a common mistake.


The outside of my bedroom door and my bedroom walls were covered with study sheets. It is nice because you can review material when you are just brushing your hair or whatever.


Some more pictures of my bedroom wall.
After available wall space in my bedroom was expended I moved the the bathroom (with my roommates' permission, of course). Andrea said she enjoyed reviewing material while brushing her teeth, etc, but I think she may have just been saying that to be nice.

The pen/highlighter graveyard. This isn't even all of the pens and highlighters I used while studying for Step 1. I decided to start saving the pens/highlighters about a week and a half into my studying.
Now you can get the picture of how messy my room was while I was studying. I had a pile of books and note-taking supplies that I moved around with me as I studied in various locations throughout the house. good times. Now I am off doing my clinical rotations.

Birthday hike and other pictures

A lot has happened since the end of spring quarter. I decided to give the photographic tour of the last couple months.

Med school graduation for the 4th year class (it will be me in 2 years!): I know several people in the fourth year class so I decided to go and take pictures to be supportive. It was a nice ceremony, and inspiring that they all got to take the Hippocratic oath, but if any of you plan to come to my ceremony - bring pillows! The stadium chairs are something to be desired.

This is Andrea, or I guess as I should call her now, Dr. Andrea, one of my roommates for this year.



Melissa, my roommate from the previous 2 years, also graduated last month. Here she is with one of her sisters and her cousin Betsy. Although Melissa has left me, Betsy is still here and we get to hang out sometimes which is fun.
Here I am with Katja on her birthday. Katja is a friend that I know through my classmate and friend Sarah. Sarah and I organized a birthday picnic for her (but Sarah did most of the work - baking the cake and the main dish).

Katja holding her birthday cake.
At the end of second year we gave our ICM II mentor, Sam, gift at our end-of-the year breakfast. We gave him a pretty funny coffee mug.
Here is another picture of our ICM II group (I am sure my blog readers are tired of seeing them by now). ;) They are all such cool people.

The next big thing was that my older brother came up for a surprise visit for my mom's hip surgery. We have a couple pictures from surprising mom. She had no idea he was coming - it was great!
My little sister, Monica, during the surprise.

My brother, Aaron, with our mom. She was pretty happy.
This is me with one of my favorite elderly women at our church. She is so sweet - she sends birthday and anniversary cards to every one in the church every year. It is pretty incredible.

Me with my momma.

Me hanging out with my bro' waiting for mom to arrive for the surprise.


In June I turned 25! To celebrate the big birthday, I went on a hike with my good friend Sarah from med school. We hiked up Mount Bandera. It was beautiful as well as good exercise and a lot of fun!

Me at the pseudo peak of the mountain (the real peak was just a few feet away and blocked by a snow slide).
The view from the top of the mountain. It was pretty!
Even though it was a warm day, our path had snow towards the top. You have my permission to be impressed. ;)
More pictures of the view.
Me standing in front of a waterfall. The water was nice and cool.
Here is Sarah in front of the same waterfall. It was a really fun day!