One Month Until Fourth Year

   Yeah, I am still alive.  I've just lost track of time in the always-changing flip-flop sleep schedule that is Q4.  I am writing during the wee hours of my last overnight call in Internal Medicine.  Everyone said this rotation would go by fast, and shit - I believe it.  After this shift, I switch over to Kaiser for one more month of Internal Medicine, and then we officially start our 4th year!  This last month has been pretty darn busy with scheduling 4th year, long hours on IM wards, and trying to get some studying done.  Unfortunately, this rotation is so exhausting, I hardly have energy to study during the few hours I get off here and there.  Hopefully I didn't screw myself with my grand plans of only taking 2.5 weeks to study for Step 2 CK. 

   This last month has had its good notes and bad notes.  I'm enjoying the learning, and I continue to be humbled on how much there is to know.  I'm enjoying the patients, especially the characters.  In terms of my team dynamic, well, let's just say there is something to be desired.  We have an attending who loves to feel smart, so makes everyone else feel stupid in the process.  She is extremely unessecarily nit-picky and critical of everyone and everything, however, her criticisms have actually allowed me to realize how far I've come over this year.  For example, she was critiquing me on my lung percussion technique, which by the way, a cardiologist had just complimented me on a week earlier, and condescendingly ended with, "Sweetie, just practice your technique, ok?"  If this were to happen earlier in the year, I probably would have been very upset, felt inadequate, and doubted my abilities.  But when she told me this, I just laughed it off to myself, knowing that I was happy with my technique, and that I wasn't just being arrogant, because a cardiologist had commended me on my it a week prior. 

   I can't believe we only have one month left of third year.  I've pretty much been waiting for this year to be over after finishing OB/Gyn, so I'm really happy to be moving on to 4th year.  Looking back, I can't believe how far I've come this year, in so many different aspects.  It's absolutely incredible how much knowledge you pick up in one year on the wards, so much more than you ever could in any books.  I am so happy with how much I've improved with my histories, physicals, note writing, and presentations, though I obviously still have room to continue to improve.  What I'm most proud of though, is how much confidence I've grown.  I started this year out as a thin-skinned, self-doubting, unsure-of-myself med student.  I end this year as a medical student who knows her strengths, is confident in her abilities, and has a much MUCH thicker skin.  Now that I've developed a thicker skin to deal with all of the constant criticism, I fear that my thicker skin will hinder me from empathizing with my patients.  I don't ever want to lose the ability to connect with people, and I fear that it has already begun because I've become so accustomed to keeping my walls up.  Maybe further on in my career, when I'm no longer under so much scrutiny so often, I can strike a balance between thick and thin skin.  Maybe a semi-permeable skin, if you will?

   Maybe the fact that it's 3AM is making me all loopy.  Who knows. 

   Anyway, while scheduling 4th year has been stressful, I am really happy with the way things are turning out.  There are still a few minor adjustments that need to be made to my schedule, but I am really excited about my upcoming year.  So far, my schedule looks like this:

• Step 2 CK, 1 week vacation
• SICU
• Step 2CS, 1 week vacation (annual Oregon camping trip!)
• Gyn Onc
• ED Ultrasound
• Anesthesia
• Abdominal radiology
• Random 2 week vacation in October
• ED
• Month off for interviews
• Christmas Break
• Inpatient Psych
• Perioperative Medicine Special Studies Module
• Family Planning
• MATCH
• Spring OFF - vacation to Tahiti + (insert another amazing destination here?) with BF!
• Graduation!