Hi there; Birdie here!
I haven't blogged since third year started, but I'm hoping to get back into it because now I have really interesting things to talk about--I started clinics this Monday! LSU starts clinics in spring of third year (and I'm still not sure whether I should be introducing myself as a fourth year student now that I'm Phase II). For about a month, we took 3 classes (population, ethics/jurisprudence, and infectious disease). No final grades back yet (except for ethics, which was practically a participation grade--just a few online quizzes and analysis of two cases), which is kind of annoying, but I don't doubt I passed so it's fine. We had our white coat ceremony on Feb 5th, and then we had a week off (which I spent half in the Bahamas and half visiting family in Houston and 0% studying like I'd planned to). So far I'm still not sure that I actually know how to do anything, but I seem to have retained some stuff from classes and I'm learning more all the time. Clinics are pretty awesome, and so much better than being in the classroom.
My first block is oncology for two weeks--for those of you who aren't sure, that means cancer. Whenever I tell anyone that's what I'm on first, the inevitable reaction is how it must be sad and depressing. And there has been that component--yesterday was a tough one, with a cardiac hemangiosarcoma that was euthanized. The owners were so sweet about it; they thanked me for my part in working with him, even though I really don't feel like I deserved it given how I didn't actually do much for him. And I'm not entirely sure my case Monday might not be another euthanasia. But my case yesterday was the only one all week we couldn't do anything for. Learning about cancer is really interesting, and we have really cool options for treatment. The clinicians are wonderful. Our usual oncologist isn't on clinics this block, but we have a locum from Auburn and some interns/residents. The third year resident is taking most of the cases, and she's great to work with.
We never get grilled in case rounds about details of the diseases or treatments we're working with (although I expect that will be different on other rotations, especially medicine), but the clinicians are really good about pulling you in on a doctor level. They ask about what do you want to do next on this case, or what do you think of this bloodwork finding or this clinical sign, or does this plan make sense to you based on what you know about this disease. The part that most surprised me--and makes me feel most like a real doctor when I get it right--is when they ask about medications. A couple of my patients have needed to be sedated for ultrasound, and I was expected to come up with a protocol. And when our patients have non-cancer problems (a corneal abrasion, neck pain), we're asked to come up with medications for those too. They're really chill about it, though--I'm never afraid to try and come up with something, or to say when I don't know. It helps that everyone knows it's our first block (4 of the 5 students on oncology this block are 2017ers); I'm learning, I don't have to know 100% of everything right now. My next block might be a little harder in that regard, but hopefully I do learn enough to keep up with it.
The way this rotation works is that we start each morning with case rounds, introducing everyone to our patients for the day. Then we go for topic rounds, which is kind of a lecture but mostly a conversation about whatever topic is selected for that day--radiation or chemo safety or a specific tumor type or whatever. That takes about an hour, and then we start seeing our cases. If they aren't already here, the students are the ones who go out and greet them and take a history before bringing the pet back to our area. We do a physical exam (although I should be better at making sure I get a good PE--it's hard sometimes with a painful dog who growls when you touch him, or the patient in ICU that I'm scared to mess with), and so does the clinician on the case. We as students do a lot of filling out paperwork (request forms for everything--a lot of bloodwork and imaging, whatever drugs we need, etc.) and calling clients, and we go in the exam room whenever the clinician goes to talk to the clients. We also have to write up discharge summaries for our cases. I actually wrote my first one yesterday (not the hemangiosarcoma, my other case--one of our oncology patients who presented on emergency, and turned out to have hepatic lipidosis) since throughout the week I've been too busy with my other cases and then it needs to be quickly written when the owner is coming, so the clinician takes it. I usually have at least two cases, although on Tuesday neither of my cases showed up, some days some people have had three or four cases, and sometimes I pick up another case that wasn't expected but shows up later in the day (like that hepatic lipidosis cat).
Some highlights from this rotation so far: I felt lymph nodes on a dog with lymphoma--you can definitely feel them when they're that big! I've watched a couple of ultrasounds and looked at a CT scan. And one day, a classmate and I had a little competition. The only thing we knew about the case coming in was that it had a mass on its leg. We competed for the best diagnostic plan, earning points throughout the day for things like picking the correct top differential diagnosis, noticing a swollen lymph node, knowing the right medication to give. In the end, I won (I think by only one point--it was close), with the prize being the loser buying the winner a latte. That was such a fun day--and our clinician even said that we were practically doctors handling the case ourselves! Those are the best moments, when you feel like a real doctor. Clinics are pretty awesome.
Today was open house, and for the first time, I didn't work it at all. Since we started clinics, we're no longer in charge of (or really even in) any clubs, so I didn't have to--and after working all day the past two years, I'm happy not to have to. We were offered extra credit in Infectious Disease for working (and that's why it's annoying not to have our grades back yet), but it was worth it not to have to come in. Hopefully I don't miss that extra credit when grades do come out! I also bought my NAVLE prep materials today. I wasn't planning to start until maybe May...but the sales don't come around again until the end of May, and I'd wanted to start at the beginning of the month. So I may or may not get some use out of it in the meantime. I chose to buy VetPrep over Zuku. I like the company for Zuku better: their questions-of-the-day have little cartoons at the bottom, they seem more personable and very willing to help students, and they were the only ones who came to talk to our class. But they place a big focus on visual learning, and my first instinct when I see a picture on a textbook-type page is to ignore it and just be glad it's not as much to read. Plus some older posts (which, Zuku is newer and has been adding more and more every year, so they may not be totally accurate) seemed to suggest that VetPrep was better, at least a few years ago. My best friend bought Zuku, though (which is absolutely right for her, she's such a visual learner), so if I made the wrong decision I expect I'll know about it. I don't think it really matters that much, though, which service you use; people pass with both of them.
