Clerkship: Mga bagay bagay

before going into medschool, hindi ako aware sa concrete details ng clerkship at internship. before going into medschool, alam ko lang, pag 4th year tawag don clerkship at 5th year ay internship. na ang last 2 years of medicine ay igugugol mo sa hospital training. actually before, ang akala ko 4 years lang talaga ang medicine, na ang stupid ng mga iba for choosing schools with 5 years of medicine. pero buti na lang at nalaman kong ang internship ay REQUIRED sa lahat ng Med Students (so tiklop bigla ako, kasi heto ako sa isa sa mga "stupid" na eskwelahang pinupuna ko dati-rati na may 5 years of Medicine) sa loob loob ko kasi noon, ang strict na nga ng requirements ng St. Luke's na yan tapos 5 years pa yung training! wag na uy! naiintindihan ko yung sa PGH, UP yun eh, gusto nila matagal training para man power! (nakakatawa pala pag-iisip ko noon)" Man, was i ever wrong. Pero still, One of the reasons I chose SLCM then is because they had the 5-year thing going for them. I was thinking then (nung nalaman ko yung internship thing ay required before taking the boards) "Ayaw ko ng ma-hassle pa at maghanap pa ng papasukan sa internship, dun nalang para diretso, atleast mafafamiliar ako sa environment, besides, St Luke's is still St. Luke's anyway) so andito nako! Lols

Information I WISHED I KNEW and UNDERSTOOD FULLY BEFORE GOING into MEDSCHOOL


1.  5 years. You will study Med for 5 years before you can take the BOARDS and be able to practice      Medicine (bago ka makareseta dude),

• 3 years for academic/classroom learning wherein you'll learn fundamentals of medicine (THE BASICS: ANA-HISTO, PHYSIO, BIOCHEM, MICRO/PARA, COMM MED (?) PHARMA (?) PATHO (?) and LEGAL MED) *the (?) ones kasi considered basic pero mejo clinical na din, parang asa gitna sila
• 2 years in the hospital to practice and apply your Hx and PE skills and your Diagnosing and Managing skills and learn first hand patient care  

2. PRE-DUTY-FROM STATUS - ito yung pinaka-importante para sa akin. Kasi hindi ko talaga siya maintindihan before, narinig ko na sya pero hindi ko pala sya naintindihan fully until i was being oriented before clerkship and noong naeexperience ko na sya. I won't lie, nabigla ako and i felt so tanga for not knowing such a critical information. atleast hindi ako mag-isa, hindi lang ako yung nashock at ngumanga nung sinabi nila what PRE-DUTY-FROM is, so here goes

• PRE STATUS also PRE-DUTY - ito yung time/day bago ka mag-"Duty" day, ang sabi nila, ito yung araw para mapractice/maghanda ka bago ka magduduty, like knowing who you're patients are going to be and what to expect or do on your duty day. Sa St. Luke's iba iba ang time-in nyan, it can either be 630AM, 7AM, 730AM 8AM or 9AM. Dismissal time is universal at 5 but can be earlier or later depending on the department/if your work is done. 
• DUTY STATUS - ito na, magduDUTY ka sa hospital, you will stay in the hospital for 24 hours! walang mintis yan 24 hours ang "DUTY period" mo sa hospital so kung 630AM call time, 630AM  to 630AM (the next day) ang "DUTY" mo, pero here's the catch, the FROM status.
• FROM STATUS / FROM DUTY STATUS - so nag "Duty ka na, 24 hours ka ng asa hospital, pagpatak ng call time/time-in mo the next day (kung 630AM, 630AM next day, etc) considered "FROM" status ka na. Ito ang masaklap. ang "FROM" status ay kapareho ng time period ng PRE, uuwi ka ng 5PM that day. Gets mo ba? in short, kung 7AM halimbawa call time mo, papasok ka ng January 1 7AM, uuwi ka the next day ng January 2 5 PM. Kung di mo nabilang, yun ay a total of 34 hours na nasa hospital kang nagduduty.
• Sa St. Luke's may special rule na kapag pumatak yung PRE mo ng SUNDAY or HOLIDAY considered OFF ka. that is, may DAY-OFF ka! so kung ang isang buwan ay may 4 SUNDAYs, siguradong may atleast 1 day kang DAY-OFF for the MONTH! grabe ang swerte noh? (no, I'm not actually happy, I'm being sarcastic) AND kapag FROM ka ng Sunday or Holiday, AS RELIEVED ang status mo, ibig sabihin, pwede ka ng umuwi the next day kapg dumating na yung DUTY for that day. (saya ulit no?) so again, atleast may 1 kang AS RELIEVED status.
• SPECIAL NOTE: OTHER Hospitals do not have a "FROM" status. yung iba, kapag DUTY ka, after ng 24 hours mo, uuwi ka na. but not in St. Luke's and PGH if i am correct. basta ang alam ko walang FROM status sa UE at UST, sa UST mas maganda actually, ang alam ko ang pasok ng DUTY sa kanila ay 1pm (though not sure 100% about that)
• AUTHOR's NOTES: Oo hanggang ngayon may issue ako sa scheduling na yan, kasi kung sinuswerte ka, may chance na for 1 week you will spend 108 hours sa hospital. Tanggap ko ng ganyan talaga ang scheduling pero I can't help but ask, bakit hindi maadapt yung ginagawa ng iba? bakit hindi pwedeng walang FROM status? bakit hindi pwedeng gayahin sa training institution na may 60, 70 at 80-hour week tulad ng sa ibang bansa? just a thought, pero I'm too coward to bring it up further aside from me ranting here. lols. and to be honest, kahit natutunan ko yung PRE-DUTY-FROM (PDF sked) i think i would've still gotten into Medicine.

CLERKSHIP TASKS

• This is way too varied to discuss and syempre, St. Luke's perspective to dahil malay ko ba sa ibang school, puro haka-haka at kwento lang naman ang alam ko about them. Sa St. Luke's depende sa department or rotation mo at sa day or status mo, iba iba talaga ang task, 
• First off - ER tasks (take history, pe, update labs, get results of imaging, log the patients in log book, do census, discharge patient, give instructions to patients on their medication, and things to watch out for/ when to come back, explain why a certain laboratory/blood exam is requested, or what is wrong/disease they have or how they might have gotten it) for me, ER is the most rewarding rotation. and i am actually considering ER medicine if only I'm not slightly (ah wow, underestimating) overweight, haha (hidden trophy lols, ps3, or that is, silent requirement) na dapat may kaaya-aya kang BMI para matanggap sa ER Med (huhu), 
• Next WARDS - kakamustahin ang mga admitted na patients, check if the patients have complaints and do PE, update the consultant or resident. In St. Luke's almost always lahat ng galaw mo may residente ka, emergency status mejo rare yan kasi dito, hinding hindi ka mag-iisa, lalo na kung expected na critical or unstable status ng pasyente. Kasi defensive practice tayo, syempre, ayaw natin magkamali at may masamang mangyari sa patient. Para sa akin, this is the most nakakapagod part of any rotation, nasa iba-ibang rooms ang patients mo at nasa iba-ibang floors. Tapos kapag may consultant na dumating, masisira lahat ng plans nyo for rounds at sasamahan said consultant. KAPAGOD!  
• OPD (out-patient department, charity cases) do complete Hx and PE, diagnose and give medications/ do work-ups. Dito, ikaw yung attending physician/consultant. pero syempre, kailangang ipacheck sa residente. Actually minsan simpleng Hx and PE ka lang kasi residents na ang magdadaignose at magbibigay ng gamot. But still, ikaw una nakakita sa patient eh, so ikaw dapat, meron ka ding diagnosis or differentials in your mind and the possible management/treatment for the patient. Mix emotions ako dito kasi sobrang nakakairita yung OPD with all the politics and the not so friendly nurses/staff (Actually 2-3 lang naman sila, pero nakakairita sila) Rewarding sometimes, exhausting sometimes especially when you're patients are difficult to communicate/talk to. 
• OR Duties - ito depende na ito. For people who are inclined to surgery, then this is heaven for them. For me who hates standing for hours at the time holding/pulling/pushing instruments for residents/consultants to operate, it felt.... hellish (yes, theme song sa utak ko yung "Jealous" ni Nick Jonas right now). Kasi hindi ko kayang pigilin ang ihi ko ng matagal at ayaw na ayaw kong tumayo at tumanga for a long time, hindi ko appreciate ang OR duties. Here, ikaw mauuna sa OR, babantayan kung dumating na pasyente at i-update mo ang residente mo. Kung may kelangang materials na ipa-prepare, ikaw magsasabi. Kung out-patient procedure yung OR, ikaw gagawa ng paper. Kung may imaging like CT scan plates, MRI plates or Xray films, ikaw din magdadala minsan. Ikaw din gagawa ng Operative Techniquqe (kung anong ginawa nyo sa OR). And most of all, ASSISTING. This.I.Hate. Kasi role ng clerk ay mainly, to retract. You will retract that annoying bowel/innards that keeps getting in the way. Or the skin/fascia/muscle that obstructs the surgeon's blade or instrument. For Mastectomy (one the worst ORs ever) skin retraction means pulling your patient's skin upwards to dissect off them breasts. Not only are you watching your surgeons remove a perfectly well looking, albeit malignant breast, but they're also making you ache all over. well, yung elbows mo lang naman kasi hinihila yung balat pataas for an hour nakaangat lang kamay po, that was hell. lalo na kung yung breast mass na tinatanggal nyo ay Cup C or D. Pota.....Makes me hate boobs. Or yung matatagal na ORs (hello Whipples! Laryngectomy! Total Maxillectomy! or any other 8-15 hour (yes, 15 freaking hours) ORs) Hindi ko ata kayang tumagal ng 6 hours ng hindi umiihi! (lols, unless tulog ako) kaya no, no, no, i love my kidneys please. Although masaya sya and most of the time, kapag nakikita ko at naaappreciate mo yung anatomy ng OR, nakaka-invigorate, pero when you are way too big and will obstruct the surgical field and is asked to lean away, but keep retracting from a distance. nakakapagod and nakakadegrade. Also, kung mabait or SS yung patient, suturing, patatahiin kayo! oh diba! yehey! haha OR tasks din from OB is delivering a baby (syempre hindi high risk cases) delivering placenta and suturing the vajayjay. 
• OTHER MEDICAL STUFFS - Discharge Summary ng pasyenteng inadmit nyo at pinauwe, so ikukwento mo history and pe ng pasyente at kung ano ngyari sakanya sa hospital. Sa surgery favorite ko tong ginagawa kasi nakaupo kalang, nagbabasa at nagtatayp, medyo may matututunan ka din naman ng kaunti like kung anong ginagawa sa patient when they develop something or watever. PLUS nakaupo ka lang! yey! (dapat talaga hindi nalang ako nagmed at nagpaka-office worker/call center agent na lang ako, lols) Admission! Do History PE and Problem List Database. which is very annoying kasi sinulat na nga sa order sheet ipapasulat pa sa lintek na database.. i swear.. what is the point! #conservetrees #recycle #mothernature kainis! at kung nasa ENT ka (my pinaka-favorite [insert vomiting smiley] rotation ever!) isusulat ninyo sa ER sheet, gagawa kayo ng Green Referral notes (kahit kayo yung admitting service at hindi naman kayo ang nareferan, talagang feeling ko ang tanga tanga ng ginagawa ko at sobrang sayang sa papel, kaya ata mahal magpagamot sa st lukes eh!) isusulat sa Order sheet/Doctor's notes at gagawa ng freaking Database na 21 pages! 21 pages! as in! 21 pages! Other medical tasks, IV insertion, Blood extraction, NGT insertion, Foley cath insertion. 
• OTHER NON-MEDICAL STUFF. Most important payo sa akin ng naging Intern ko, (Non-verbatim) "Mas madali ang buhay mo kung matatanggap mo agad na Clerk ka, like it or not, sa hierarchy ng Doctors, ikaw pinakamababa, alam kong masakit tanggapin/marinig pero yun talaga most effective way of saying it na madaling maintindihan. Hindi naman porket lowest of the low ka hindi ka na respetado or what eh, ikaw lang kasi yung wala pang experience or yung may pinakakaunting experience. Isipin mo na lang na kung may pasyente diyan at may kung anong mangyari sa kanya baka hindi mo pa alam gagawin eh. Mejo life-changing/traumatic experience din kasi yun para sayo. Ako iniisip ko na lang na kaunting tulong ko nalang sa residente yung non-medical tasks, kasi sila napapagod din sila, tapos tinuturuan pa nila tayo. kaunting tulong lang naman din yun for them." So ano ba yung tinutukoy nyang "non-medical" tasks. to be honest, kahit ano. may nagpapabili ng pagkain, nagpapabili na kung anu-ano, nagpapahanap ng kung anu-ano. nagpapabitbit. sacrificial lamb sa consultant para magtanong ng kung anu-ano. call center agent kasi magpapatawag sa kung saan saan para magtanong ng kung anu-ano. as in anything and everything under the sun. 
• Famous story ever, is may isang consultant, itago nalang natin sa specialty na Psychiatry (as in, sa Psych pa talaga ha! considered benign rotation) na nagpahanap lang naman sa hamak na clerk ng Helicopter. as in. kasagsagan ng bagyong Ondoy (yes, clerkship year nila si Ondoy) ng kinailangan daw ng helicopter ng isang VIP patient ng helicopter para masundo sya (somewhere) at magpakonsulta kay bigtime psychiatrist. and need i say more, sumabog nalang yung clerk. #watdafack #sanakohahanapnghelicopter #meronbasayellowpagesngrentahelicopterservice. in fairness, tumawag daw siya sa redcross who redirected her to the army where she eventually was able to inform them of the need for a rescue.... potang inatalaga! buti nalang nung kami ang nagpsychiatry, ang pinapahiram lang naman nya ay piano, sabi namin kung yung organ ba na piano, hindi daw... yung grand piano... but portable.... (promise, nag-migraine ako after)

HOSPITAL ENVIRONMENT
 SPECIAL ENDORSEMENTS

• Time-in: sa Surgery at Medicine 630 AM dapat asa hospital ka na. (lalo na if you have an early OR sa surg or you have patients to do rounds to sa Med) in Neurology, ENT and OB 7AM, 730 sa pedia. 8 sa Ophtha, Radio, Patho, Derma, Psych. 9AM sa community med. Time-out is usually 5PM or earlier depending on the department and the work for the day or later depending on (again) the department and work that still needs to be done. Some departments are notoriously known na for early and late dismissals. Neuro, ENT and Surg (in descending order of frequency and intensity) are heavily endorsed (Med lingo, endorsed/endorse/endorsement term used for everything and anything you "teach/say/advice/habilin/chismis" to other people) as Departments where you may be asked to extend beyond the dismissal time. Neurology is a very tough rotation, as expected and as kwento by most doctors, kasi IT IS NEUROLOGY, utak kasi pinaguusapan natin teh

Sophie Year - Adjustment Monster

Nag-aral ako ng highschool sa pisay, at isa sa mga kinakatakutang taon dito ang 2nd year. sa totoo lang, tama sila kase 2nd year lang ako nagkaroon ng bagsak na subject sa isang quarter! ay sos! di ko na matandaan ng maigi ang full details pero grabe, yung feeling na papatawag ka ng adviser tapos kakausapin nanay mo, sheiz, nakakaiyak.

Sophie Year na ito ay mej magkapareho, lols.

2nd year sa med. hinga ako ng maigi kase tapos na first year, and scholar ako! Yey! So malamang sa malamang yakang yaka natong 2nd year nato! So subconsciously (sometimes consciously) akala ko same lang! Boy, was I so ever wrong!

First of, transition from Basic Science to Clinicals so mas maraming subjects! Requirements din dumadagdag kasi may Micro and Patho na both may lab. Papers din because my small group discussions na sa clinicals! (Update: SGD used to start in 2nd year pero St. Luke's started doing them for first years! yey, though mas "tame")

subject-by-subject

Pathology (Patho)

Ito ang "in-between" subject sa second year. Tinuturing nila ang 2nd year as sortof pre-clinical-clinical year kase may ituturo silang clinical pero foundations/basics parin ang kailangang i-instill. So in-between ang patho kase sortof clinical siya kase may clinical information about diseases ang malalaman mo pero grounded on basics like physiology, anatomy and biochemistry para maintindihan mo ang pathophysiology ng disease or in other words, what the eff is happening wrong in the body/system/organ/tissue/cell kaya nagkakaroon ng ganto-ganyang disease.

PROFS:

IMO, thank god for this subject, not only will you learn A LOT from this subject, its very helpful na handled by the department head god-sent to everyone Doc Moria. Ay sos! Grabe sa kabaitan kung mag pa quiz (Case Analysis=Quiz) at sobra pa magturo yan pag di mo naintindihan ay ewan ko nalang sayo. (unless natutulog ka, 1/2 wink)

*other faculty dito, lalo na si Doc Carreon ay note-worthy din naman dahil kapag magbigay ng tips/hints to, ewan ko nalang sayo ulit kung di mo pa makuha (unless natutulog ka ulit, wink-wink-wink)
UPDATE: Doc Carreon passed away na, kami ang last batch na naturuan niya for 1 full year, huhuhu. Truly a loss for everyone, kasi magaling siya.

*pumalit kay Doc Carreon si Doc Jeff So. Madaming nahuhumaling sa kanyang kapogian. Haha. Specialty niya ay prostate pathology sooo.... mejo green-minded siya. haha. *lahat pala ng sinasabi ko tungkol kay Doc Jeff is from my clerkship days. Though from what i heard, aside from personally knowing na magaling siya magturo, majoke siya and approachable din. Most importantly, (i-emphasize ko daw sabi ng friend) guwapo siya, hahaha. side-note, wag mong paalam na taga Pampanga ka kasi ibubully ka niya in Kapampangan (like me, huhuhuhu)

may mga guest faculty din dito at most probably maeencounter mo din sila sa other subjects (micropara at medicine). 

EXAMS:

kaibigan mo dito sa subject na ito ang textbook na si Robbins, ay sos, word-for-word mo lang yung "Pathophysiology-Morphology-Outcome" ng disease, guaranteed 8-10 ka lage sa quizzes.

BEWARE topics ni Doc Carreon ay CASES (as in mahahabang case with pertinent info like morphology (gross at histologic) at SSx na medj characteristic ng disease (na nilecture niya) yun na yun.
UPDATE: Mejo hindi daw gaanong macases si Doc Jeff So, pero siya yung mahirap yung questions.


Sa lab naman, dito ka makakabawi basta makinig ka lang sa lecture during lab session, or kung magaling yung transcriber nyo at nanote niya yung mga inemphasize talaga ni Doc Moria sa slides.

sa projection exam naman (magpoproject ng picture and may side question) ni Doc Carreon, Robbins lang ulit, yung mga picture lang sa COVERAGE ng periodical (nahahalata ko pero minsan mas marami yung mga tungkol sa nilecture niya) tip, yung mga picture na may kulay yung background or may ruler etc madaling tandaan, i know its so wrong pero its so helpful na alalahanin yung kulay or yung ruler instead of the look ng disease T__T
UPDATE: Still the same, hindi lang si Doc Carreon nagbigay, though nauuso ang internet pics ni Doc Jeff So, not sure now.

Microbiology-Parasitology (Micro-Para)

Pangalawa lang to sa aking subject na to (most probably sa like/dislike at sa projected grade) kasi nahirapan ako sa dalawang block dito (namely viral at para 4th block). Tungkol sa mga Bacteria (1-2) Viruses (3) Protozoans (4) Worms (5) Kung anu-ano (insects, continuation ng worms, at medj integration ng lahat, kaya 6th)

PROFS:

swerte parin sa subject na ito dahil kay Doc RFF, favorite ko na talaga siya dahil sa subject nato. halos kailangan mo lang talaga kay Doc eh ang kanyang ever-trusted lines of "Take this down" questions during the lecture, basta sagutin lang ng transcribers ang mga tanong niya sa lecture, trusted may points ka for sure (wink-wink) :) Doc Malaya is different however kase she wont give hints (sa pagkakaalala ko, wink-wink) about possible exam questions pero her lectures are definitely easier to follow, kase admittedly si Doc RFF nagjujump from slide-to-slide kapag naglelecture ^__^ (nakakalito/sakit ulo minsan sa umpisa pero in the long run nakakaaliw na din yan, hehehe).
Mostly si Doc RFF din sa lab magtuturo, occasionally lang si doc Santos.

EXAMS

Mostly madali yung exams, lalo na kung nakapagfocus ka talaga dito (2nd and beyond reading?)  at mga matataas dito nakaka 97-98 dito (grabe diba?) kaya yakang-yaka mo yan.  kung kelangan mo talaga yung GWA mo at hindi mo kelangang mag-focus sa isang subject (dahil nanganib ka tulad ko, hehehe) suwestiyon kong dito ka nalang magfocus kase mas malaki ang percentage nito (kesa naman sayangin mo yung oras mo sa isang semstral na sigurado ka nanamang 80+ dun, again hindi tulad ko, dahil nanganib ako sa said semestral subject, cough Neuro) lab exams lalo na sa  projection ay very very fair at usually maaalala mo yan sa lectures nila (lalo na si Doc Santos) TIP sa transmaker sa lec eh kapag naglalagay ng picture, maglagay  ng pictures from the internet kase minsan yung lang din yung  pinaghahanapan ni  doc. sa lab exams, uhm, pana-panahon din minsan, may tsismis noong kumalat samin na nagtanong daw si doc RFF ng  lab procedure question (agar, stain etc) pero hindi naman siya nagtnong samin ng ganun. may tsismis ding mas maingay/naglalaro sa lab mas mahirap ang exam, pero ewan ko lang sa warning na yan ni Ma'am Lenny, probably panakot lang, kase kahit anong gawin ko lagi akong nahihirapan sa lab eh! hahahaha

Pediatrics (Pedia)

I know, its not going to be my 3rd highest subject (kase may ethics at psych) pero I really loved this subject without a doubt, maybe biased ako kase nasa top 3 choice ko ang pedia pero i absolutely stand by my opinion. topics mostly cover history taking and physical examination, growth and development, fever, cough, diarrhea, immunization, nutrition. Nag-iba na ito kasi nag-iba lecturer, mas madali na ang Pedia pero last kami ni Doc Rivera (swerte talaga namin) kaya mahirap yung Growth and Development part, ang referrence niya ay Mother Nelson's at Preventive chorbs (sorry nakalimutan ko tawag, di ko na mahalungkat yung akin eh) na gawa ng PPS. the other 2 semesters are easier. 

OB
Intro to OB, madali-ish siya for me kasi naenjoy kong basahin yung Williams (pero yung iba naguguluhan sa Williams kasi madami siyang statistics na sinasabi) tsaka magaling yung OB profs, though may mga oh-em-gee questions na minsan lahat pwedeng tamang sagot naman. still, kayang kaya kung aral ng maigi ang transes.
Paper: Bawal malate sa papers here, pampahatak ng grade ang papers dito (actually sa lahat) so don't forget!

Medicine
Okay naman siya kaso may Clinical Integration so minsan magulo. May pauso pa silang SGD based questions kaso super unfair kasi magbibigay ng questions yung Prof ng bawat SGD group na hindi naman matatackle ng ibang group so pwedeng may Renal question or Cardio question samantalang Pulmo block, huhuhuhu. Inayos na nila yung exam kasi super fair at nagreklamo kami, (syempre previous batch ang nakinabang, harharhar) SGD papers: seryosohin this kasi mataas ang bearing. Don't fret kung pangit first papers mo kasi ganun talaga. Mangiyak ngiyak nga ako nung nilalait nung professor yung differentials ko eh, harharhar, 1st SGD, 1st week ng 2nd year, sooooo memorable.... wala siyang paper na nagustuhan haha, excuse my language, he's such a whiny betch talaga. (memorable siya kasi siya lang ang alam kong laiterang prof sa IM, feeling namin bakla siya, pero may "wedding ring" siya eh, hmmmmm... *wink-wink)

Psych
Ok lang, study study the transes, papasa ka. Psych to the stars ang Profs dito so mga kwento nila is, my starlalaet who had this or that, nakakamemorable na nakakaaliw, hahaha. Kaya tong subject nato, walang bumabagsak sa Psych

Surgery
Mahirap to... dati.... ngayon, sobrang hirap nito, lols, nag-iba ng faculty so i dunno. No comment. Mahirap, aral maigi, may umuulit nitong subject na ito. Faculty is same sa hospital, dati kasi not affiliated sa hospital. Oh well. Doc Decs also teaches here, pero super hard na questions niya, hahaha

BRS
Pota. yun lang. i think 4 - 5 exams lang ito pero wow. always aral and prioritize this betch kapag may exams. Profs: from RBD section ng hospital (Research and Biotechnology Division) mga PhD profs. kung mahilig ka sa MBB appreciated much mo ito. Ako i liked Cell Bio in college, sa medicine, hate ko to, harharhar. mejo boring kasi lecture. harhar, what is may muntik maheld back kasi sumobra ang absent nila, huhuhu

Ethics.
Doc Solano. nuff said. easiest to, swear. minsan dalhin sa common sense/angelic behaviour, harhar. may debate dito, ewan ko lang ha, dami namin eh. piliin niyo yung emotional ang reporting, lols. tsaka yung forceful.

Clinical Pathology
Extension ng Patho, topics dito. CBC etc. haha. easier to kaya kayang kaya, surprisingly highest ko to sa lahat ng semestral subject. (or tie sa Pedia? ata, haha) Profs same sa Patho

   

From 1st to 2nd

So here I am, i have survived 1st year of medicine, considered by most to be the easiest year for a medical student, yet I do think it is a very important (if not the most important) year since it will test you and make you realize or understand what it is that you are (forcing?) facing for three or four more years that will actually progress or continue as we graduate and be clinicians. (remember, learning doesn't stop in the next five years of med school, it goes on. learning doesn't stop. period.)

Anyways, I did survive SLCM 1st year! yahoo! unfortunately for our batch, 13 was cut from our family and good-byes are really difficult. Sadly, 1 out of 13 included a close friend and it was really, really sad experience. I'm gonna stop there cause talking about it will probably bring tears to my eyes again (*sniffle) but let me say that med school can and will mend(tama ba?) strong bonds because the terror(ah wow) and stress it puts students into is significant.

So, you survived first year eh? Well prepare yourself to a new kind of hell that is 2nd year.

A lot of doctors would say that 2nd year is a true test for a med student. It will define your capability to be a doctor, whether you have the talent or real effort to survive this year practically defines your chances of surviving 2 or 3 more years.

First impressions.

                Well the previous batch before us gave us a pep talk (sortof warnings actually) about the year we are about to experience. They even made us a cute little guide about subjects, profs and 2nd year life in general you know?

                My first impression, more like the stand-out impression about what they said and wrote was the fact that 2nd year is a bitch. Factors to its bitchiness include the number of subjects, the paper that will pile up week by week, not to mention their deadlines will not be considerate at all, the professors are clinicians mostly, so they practically treat you like residents, the subject matter is clinical now! applications of what little (or a lot, if you're like,  really smart?) that was retained from your 1st year anatomy, physiology and biochemistry and lastly, time. It seems like time is never your ally in second year, a lot of things to do, too little time. (unless you fore go sleeping, eating, socializing, sports, *even bathing? ewwww...... to accomplish your goals) 

              Based on experience for the first block (I'll make a separate academic entry) those are true and accurate warnings (except the bathing part, I did bathe). Sortof, since the papers aren't really pilinig up yet because they're really considerate because we are babies, we don't know how to walk, talk or move around a clinical setting yet (unless you were a nursing student, then f*ck you cause you know a lot! haha...bitter me)

so they don't require papers yet (depending on the preceptor) and they don't grade the first papers you do and submit to them. The topics are toxic though, especially the clinical subjects of medicine, neurology and pediatrics. they.are.a.bitch.among.bitches. in my experience, these subjects ate me alive (though results are not out yet...) Coolest subjects are med ethics and microbiology (weird enough, i had a higher grade in patho than in micro--> which is considered easier) not to mention that patho and micro has the best teachers for the year (there, i said it, no turning back now). 

        

                I don't hate medicine, neuro and pediatrics though. On the contrary, my favorite subjects, based on topics are medicine and pediatrics. What i hate about them are the exams. They are seriously difficult. A lot comments that the exam level is that of a resident. Especially in Medicine, they ask very very clinical questions like diagnostic tools. (thank the gods for they will ask management and treatment next year!) which is confuing for a lot of us because we want to concentrate in the technical aspects of the diseases they thought us first, like signs and symptoms right? It was truly confusing for me because i did not expect diagnostics at all (like CXR, CT-Scan, Bronchoscopy etc) for very specific diseases. Plan or guideline for diagnosis depending on the history and presenting S&S (sign&symptom) of the patient was specifically asked. (like if the patient is susceptible to this or that, presenting with this S&S will have a specific diagnostic tool, if not presenting with an S&S then another tool could be used, etc) which was really ahem, difficult for my level. *cough, practically breaking my disclaimer of no academic entry here. BUt that is practically what's hard for medicine, they expect ALOT from us, which so not surprising if you think about it actually. We are in SLCM afterall, to be the best is our destiny (i typed that while the pokemon theme song is playing inside my head, weird...) Neuro is practically the same, but my real problem with this subject is the curriculum. The second topic was Lesion Localization (which includes extensive knowledge of Neuroanatomy including Sensory and Motor Systems) which are then discussed after the localization lecture. (imagine, Motor system is only being discussed now, it is the 2nd block dude, a little too late don't you think???

                Anyway, for Pediatric, because it is one of my Big 3, it deserves its own paragraph. We only had 4 lectures for pediatrics. yet those topics are very thick if you look at the book sources. In my honest opinion, the Pediatric department has one of the best sets of educators in the college. It is expected right? they handle kids and it is very difficult to impart knowledge to these little tykes and handling them requires a certain patience, light attitude and enough knowledge to a successful time with them. So what's the problem then? None at all, the exam questions were truly shocking though. A lot of the quesitons weren't mentioned in class at all. It was understandable though, Dr. Rivera did advised us to read the reference material. (though for the life of me i till didn't see some of the questions he asked there, maybe i was reading the wrong book?) It was painful to take the exam of a specialty you are considering to pursue only to find out that you might not have the raw talent for it? depressing....... anyways, the results will say it all. though a text message from the class president tells us otherwise, in the History of SLCM, lowest grades of a class in pedia was obtained by us. GO 2016! record holder!

                 Other subjects (Psych and Med Ethics) was considered the easiest subjects for 2nd year was surprisingly hard for me. not totally hard actually (87 transmuted score for the exam? not bad right? though my goal was 90 actually....) Psych was totally different though. results are not yet out but I'm seriously dreading that exam. It was a slap in the face. A subject people considered easy last year is kicking my ass, and it's winning..... The exam was difficult, the cases confused me and i was totally caught off guard for about 2 parts of the exam. Preparation is the key for psych i guess because my preparation of 4 hours prior to exam review didn't cut it. it needs more time apparently.....

                    So, more impressions! I was really thrown off guard in the other subjects, especially the clinical ones, (medicine, neuro, pedia, even psych) where in one topic is taught by a different professor. Also the fact that there's only 4 topics for psych, neuro and peds included in the exam was shocking since you'd think it be an easier read right? but think again, it means more reading work for us! In psych, it messed me up because I didn't put enough effort to differentiate the mechanisms deeper, probably due to my fear of flunking neuro terribly (which i think i did anyway?) which caused me disregarding psych more.... huhuhu.. An upper year advised me before that don't take psyvh for granted, yet i still did that. how could i forget her advice! damnit! I forgot to mention pharma, it is one of the difficult subjects because of memorization it requires. But in the first block, understanding is more important though. Drug names didn't come out yet, more of their activity though. The exam was relatively easy, nobody failed :) I wonder next block though...? It wasn't surprising though, the ladies of Pharma dept are really good lecturers. Doc Almoro teaches in a jolly experienced based way while Doc Tajan teaches in an intimidating, memorable manner (sobrang effective ng approach niya promise!) which practically guarantees that the topics are engraved inside your head. That's why i regret missing a class from her, most of my mistakes came from that missed lecture! damn....

                   Yup, that's practically it for my impressions, i think I actually failed in my goal of making a better impression since my mind is practically pointing to post-exam jitters but I'll try to make a better entry next time :)