Football.

And so it begins. The NFL Sunday opener was today. The real opener was this past Thursday, but I don't want to talk about that.

It is finally starting to feel like Fall. Football on Sundays, the air is dryer, and I have my first seasonal cold. So long summer 2011, you were nice while you lasted. Thats okay though, I love fall. And it would be my favorite season if it weren't for the fact that it heralds the coming of winter. I need to live where it is always warm. Florida? Georgia? Surely not Arkansas.

Anyway. Outpatient Pediatrics goes well, and it is a fine lead in to MNPS (Maternal-Neonatal-Pediatric Service) which is next month. 6AM start times are going to be a real bummer, but I guess that's just the way it goes. It might even be nice, because as soon as this round of MNPS is done I will be DONE with Obstetrics for the rest of my life. As a doctor at least, as a husband I suppose I will get some more exposure when Mandi and I decide to have kids. Should be fairly different.

After that its only two units of FMS and I am outta here. At least in terms of hard duty. June can't come soon enough. I have had enough Peoria. Enough residency I am ready to be DONE.

In other news, I will be headed to Monticello this week for the Kirby Hospital VIP Grand Opening event. I am not entirely sure what it is going to be like. I know I had to get a blazer and a new pair of shoes. But I can't imagine it would be anything other than fun. More on that once its over.

Go Bears!

Passed

As many of you will remember from a mere two posts ago, I recently took my USMLE Step 3. The longest and final of the United States Medical Licensing Examinations.

Well as my subject/header would imply, I passed. And not only did I pass, but it was my highest USMLE score yet. Not that this is a surprise, Step 3 is often the highest score of the three. I think this is because as we march through the Steps the information shifts from being information you learn from studying to information you learn from your everyday work. Studying for Step 1 is kind of an option. Studying for Step 3 is called Residency. Not an option. It also has a lot to do with relevancy of the information. As medical science has grown... no wait, exploded is a better word, doctors have been expected to learn more and more minutiae about various mechanisms of pathology, physiology, pharmacology. We now understand things on a molecular level. Doctors 50 years ago didn't have to worry about that as much. And as important and amazing as these discoveries are, they are really really hard to memorize. For one, they are incredibly complex and second they conceptually hold little connection with the visual, visceral, real world medicine that we practice every day. Of course I know they are connected. But applying that is so tertiary that it becomes an exercise in testing and memorization.

Whereas in Step 2, and even more in Step 3 I am asked to practically apply what I have learned about Dr - Patient medicine, rather than some academic concept, or biochemical mechanism.

The incentive is easier to understand. And as we all know, effort and performance directly follow incentive.

Anyway. I passed. Yay me! Now time to go to work.


Stay Healthy.

Getting Organized, Getting ready.

Still waiting on those USMLE results. Hadn't expected them back yet anyway. Still annoying.

I have been doing three things recently worth blogging about. Number 1 I have been trying to be a good husband. I do love my Chinchy.

Number 2 is trying to get ready for moonlighting in several months. I hope it goes well, its a great opportunity to make some extra money, and get some extra experience. I am also gearing up to finish Residency and head to Monticello. This includes considering our living situation, moving, and getting all of my licensing in order.

Number three is getting Organized. This has been on two fronts. On the boring front there is the Dr. organization garbage. Again licensing, paperwork, and all that stuff. Boring. The other has been organizing my DM'ing stuff. I have recently started using GDocs to get session outlines ready, and it has been super useful. I think this, along with the wiki can completely revolutionize the way that I DM. Right now I am trying to get my players into it as well. I will be sure to keep the Blog filled in as I can.

Keep looking up.

USMLE is Done.

Well, I hope so anyway.

I took Step 3 today and yesterday. Thats right, two days of testing. Nasty. But anyway its done. I feel like I studied as much as I was expected to, and I believe that it was enough. But one can never really tell with a test like this.

You have to understand, these tests are the hardest of the hard. There are 3.5 of them. Step 1 which is a entire day of multiple choice questions that encompass all of first and second year of medical school. Step 2 CK and CS (the 1.5 tests) which are two full days, one of questions and another day of fake clinical scenarios. This is meant to encompass all of 3rd and 4th year. The final step, Step 3 is two full days of computer questions, around 400 some odd, and 9 simulated cases. Step 1 is a major determinant in your eligibility for residency, the better your score the better your chances at "more prestigious" residencies should one desire them. Step 2 solidifies that impression, and can be make or break as well. Step 3 is pretty much pass/fail, and doesn't affect anything but a few fellowships. But one must pass all of them to be federally licensed to practice medicine, a requirement to be licensed in all 50 states (and Puerto Rico). Without the training of medical school and internship a person has virtually no chance of passing these tests, and they are in place (supposedly) to weed out the incompetent.

In reality, they are a load of BULL, and a giant waste of my mother****ing time. /Bitterness. I believe I passed, I hope I passed, and I will find out if I passed in 3-4 weeks. I hope I passed for a lot of reasons. I want to be able to moon light, I want the validation, I want to know this stuff so I can count myself a competent physician... but honestly... I want to not have to do it again. Its that miserable.

Now, I passed the other 2.5 Steps, with flying colors. My scores were such that other than a few of the elitest of the elite residencies were an option for me. And by all projections I should pass this one just as easily. But one never knows until the scores come back. Here's hoping.

Either way, tomorrow my 12 day leave from work ends, and its back to the grind. The 3rd year grind its true :) But the grind none the less.

Keep looking up.

A New Day, A Good Day

Once again it has been a long time since I have posted. The past almost... year, has gotten away from me very quickly. In a lot of ways this is a good thing. While second year was better than first year it was still tough. Lots of call, increased responsibility. Less hours than first year to be sure. But still very busy.

But now here I am, a third year. 10 months from Monticello and beginning my life there. I am, without a doubt, pumped.

Right now Mandi and I are up at the lake. Bond Lake to be exact. I think of it more as heaven and home than anything else. My parents moved around so much when I was young that this place, and my grandparent's places in Monticello were the only two permanent residences I have known. And its heaven for other obvious reasons. Sun, beach, lake, boats. Everything a man could want. This is without even mentioning the best part, the company of my grandmother and grandfather. Nothing beats a week of vacation here, swimming in the crystal clear waters of Bond to wash away the first two years of residency.

But enough blogging, time to get back to more fun.

OB Call

So remember in my last post how I talked about my current rotation? And then how I stated that it wasn't that bad? Well... I lied. Or at least it seems right now like I lied. Sure its an outpatient rotation. Sure its not quite as busy as other rotations. But then there is the 5 OB calls that I have to do. And that is definitely not cool. 5 calls? What am I, an intern? And OB calls none the less. The one I am currently on has gone okay, only a few laboring mothers. But still man... OB call?

I think its hilarious that today's more established (older) physicians have a hard time understanding why new doctors place lifestyle as an important factor in choosing a location. Here's an idea... maybe if you didn't give your residents three years of the worst lifestyle you can imagine (while still following RRC regulations) you might produce a group of people a little less concerned with making the punishment end. I might consider an in house call if I wasn't so incredibly, acutely aware of how terrible it is on your sanity, constitution, love life, and personal life. Oh sure, there are arguments about continuity. And I know continuity is important... but is it worth a doctor who is sleep deprived, unhealthy, unhappy, and probably not at his/her best? I don't think so. I know that I want my doctor, the person prescribing me dangerous chemicals, the person responsible for keeping watch for dangerous illness that could KILL ME to be WELL F***ING RESTED, and if at all possible: HAPPY. If you've worked over 12 hours and you walk into my room, I am finding a new doctor.

"Oh you don't want to do OB?" they ask, incredulously... NO, of course I don't want to do OB. Every OB/GYN or FM w/ OB I have met is overworked, sleep deprived, and either A) Doesn't have a family, B) Doesn't have a family nearby or C) Is miserable. Guess what... that sucks. So forgive me if I leave OB care to those masochistic/crazy enough to do it.

/rant.

Anyway, overall today could have been a lot worse so far. I know because I have worked those days. I hope and pray I get some sleep tonight. That would be fantastic. I might even get to enjoy my life tomorrow instead of passing out on the couch for 6 hours only to wake up with a headache and a mean case of insomnia.

As an update from last week, the interviews/negotiations went fantastic this week. Only one interview left before everything can be set in stone/legally binding ink. I am pretty sure I know where Mandi and I are going to be in a year and a half (Lord willing). Its a nice place, and I feel like I can do well there. Like I said, nothing is final, still some talking to do. But its nice to be moving along.

And last but certainly not least, I got to meet my little niece! Ava Wiseheart is adorable. I got to hold her and everything. Perhaps cooler than that was watching my dad hold her. I don't know if I can ever think of him as Grandpa Sawlaw... maybe it will take kids of my own? During my time in Monticello seeing her was the highlight, but time with Dad and PawPaw was priceless as well. Even got to wrastle with Rudy Dog.

And now, back to work.

Winter is Coming

The winds were howling today. I think maybe its time for Winter. Fall will be coming to a close sooner than we would like, and the three dog nights will be upon us again. The nice thing about Winter coming this year is the upcoming HBO series on The Game of Thrones. Possibly the best fantasy book out there, closely tied with The Name of the Wind, is being made into an HBO series starring THE Sean Bean (badass). I am looking forward to watching it. The slogan for the lead-role family in that series is "Winter is Coming". Its also inscribed on this sweet sword I want to buy to hang up:

Too bad its not out in time for Christmas. Maybe next year?

It can be found here. Thats okay though, I would rather have the Damascus version.

Moving on....

Well MNPS #1 is done. On to Gyne. I can think of worse fates than that. Especially considering the first half week was ATLS (which was pretty cool) and I have 4 days off the second week because of a sweet post-call schedule and some interviews. While I will admit that I could use the Gyne practice (most male physicians could) I just can't say with a straight face that I wouldn't rather have some time off.

In other news, went to my first Roller Derby match. That was fun. Got to see a few good hits, and really, how can I complain about a game in which one scores on a JAAAAAAAM!?

And, tomorrow (er... today?) we are going to go see Here Come The Mummies in Bloomington. That should be a fun show. And after that its off to Champbana to get some Z's at the hotel this practice is putting me up in. Hopefully Thurs goes well, I have never had a bad interview, its tough to do that when you have a job with great demand. And then a mini-repeat on Friday. Then back to call. Basically, I'm busy. But not to busy to have some fun.

An update as well to my continuity OB schedule. For those of you who don't know, all FM residents have to take care of a pregnant patient during the prenatal period for at least two visits, deliver her, and then take care of her afterwards to get a "continuity" OB credit. And we need 10 credits to graduate. This is notoriously one of the tougher requirements to fill. Especially if you're a dude doc. Especially if you're a dude doc who has no intention of doing OB like me. Anyway, I got my first continuity delivery last night. Everything went great. She pushed for a while, but she made great progress and before long a very cute little lady was born. Another patient on my list. Congrats to the mother and father who will remained unnamed. Fun to have that one under my belt.

So its 1235, and I think my insomnia might be curing itself at any moment. Time for bed.