Hey guys...It's hard to believe I've already been back in the USA for a month! I was at home with my family for 4 short days before moving to New York. In NY so far I did a short 2 week Family Medicine Rotation through Bronx Lebanon Hospital to get myself acclimated to the other side of US healthcare. Wanted to ease myself in before jumping into longer rotations. I also wanted to keep things moving. I could have taken the 2 weeks off to rest and relax a little bit, but I'd rather relax when I'm finished!
The Family Medicine rotation was great. It was all outpatient in a health center. The Attendings, Residents, patients, nurses and support staff were all wonderful. The cases were varied and I learned so much in that short period of time. I'm going back in August for inpatient and outpatient to round out my 6 weeks of Family Practice.
I then traveled to Far Rockaway for Psychiatry at St. John's Hospital. Thank God for good friends and their families who rescue you in your time of need. I rented a room through AirBnB from a company that advertises to Medical Students. What was advertised was not what I got and it was in a neighborhood that left a lot to be desired. If it wasn't for my friends mom, I would have been up the proverbial creek without a paddle.
There are a number of different areas that students get placed: Consults, Inpatient, Out patient, and Psych ER to name a few. There have been some great Psych cases I've encountered so far and the Psych ER is on and popping at all times. We're learning to screen for common things like depression and more difficult subjects like suicidal or homicidal ideations...dealing with people who have auditory and visual hallucinations...doing Consults to evaluate for things like capacity to participate in medical decision making and deciding if patients can refuse treatments or medications. Psychiatry isn't my first choice of fields to go into but the experience gained here will help in any discipline and will be invaluable in future practice. There are a group of 5 students in my department, from both AUC and Ross...we're doing a great job of learning the ropes and keeping each other sane on a daily basis. Its interesting...
In the midst of the Psych rotation I also took the Step 2 CS exam...a test that puts you in contact with 12 standardized (professional) patients who have a variety of common complaints over the course of about 8 hours. We interview them, do a directed physical exam, and counsel them in 15 minutes then write up a note that includes all the pertinent information you gained, come up with potential diagnoses, and order the diagnostic tests that will help confirm your diagnoses.
Step 2 CS costs $1535!! plus travel expenses because it's only offered in 5 cities across the US (LA, Houston, Chicago, Atlanta, & Philadelphia). Luckily I didn't have to pay for a hotel since I went to Philly to take the exam. The pressure of seeing a patient, taking a thorough history, doing a physical exam, and writing an accurate patient note including differential diagnoses and diagnostic testing under a time crunch is enough to make anyone a little crazy. The goal is to take each encounter for what it is and when it's over, let it leave your mind forever. Or at least until all 12 patient encounters are over. Otherwise, you end up second guessing yourself, mulling over the questions you forgot to ask or various exam maneuvers you could have done...using up precious mental energy you need for the next patient. All I can say is I'm glad it's over and hopefully in a few weeks time I'll receive my passing score so I can move on with my life.
The best part about being back in the USA, on the East Coast, has been linking up with friends and family that I haven't seen for ages and meeting new people along the way! I'm looking forward to actually exploring New York City once I finish these last few exams that are standing in my way of obtaining my MD.
Until next time...