Friday, February 22, 2013

Guatemala: summary stuffs!

So this is the honest truth. Preparing for this trip was a nightmare. It is supposed to be a rotation. But the faculty sit back and want the students to lead, which is fine and good, but they gave the student leaders no guidance or instruction as to what needs to be done until its already due. And a peer leader, especially of some 30 odd 4th year medical students who are burnt out and just want to chat to their friends, is not going to make them do their work. Those peer leaders have no authority because there are no consequences for not listening. So it was frustrating just sitting around for hours trying to figure out what drug assortment needed to be in what trunk with what supplies in what order. Not to mention figuring out how each drug needed to be sorted and counted. It was kinda a nightmare of communication. And the faculty sorta treated it like a vacation. And who could blame them. 

Guatemala was GORGEOUS! Its just like the pictures. Warm, but not tropical and unusual plants, flower, weather, animals, and culture everywhere. There is a difference between the Mayans and Guatemalans, not just in language but also in stature. Our schedule was pretty decent. We were gone 2.5 weeks and had 8 days of clinic.  Each day of clinic was at a different village and usually lasted from 9am until dusk. We traveled on colorfully painted school buses (called chicken buses) for several hours to get to the villages on unpaved roads in moderately poor condition. Some of the villages are poorer than others, and I couldn't help but notice that we didn't really seem to stop at the poorest or the Mayan villages. I guess its a political thing being the Guatemalan govt decides where we go. But we did have very LONG lines of people waiting when we got there and always had to turn more away when we left. I do have to say that I thought 12 hour clinic days were exhausting but add to that treating people in families as fast (and as efficiently) as possible and speaking only in broken Spanish with very limited resources often in school kid chairs or church pews and exhausted doesn't even cover it. I spent most of the rides home feeling like a puddle. I was so glad we got a 3 days weekend between the clinic days or I might have forgotten my own name. 

But our days 'off' weren't really off. We spent them doing excursions-- I don't regret them, but I sure didn't get much sleep. So we hiked the Volcano Pacaya which is an active volcano pictured above. Although it looks like clouds are always perfectly positioned above that mountain it was legit steam. The freakin thing erupted while we were there, which was mostly uneventful but we did get to roast marshmallows over the lava- which was EPIC. Best marshmallow I've ever had. But it was a very strenuous climb.  We also spent some time on a black sand beach, boy was that sand hot. The water had the strongest rip tide and under toe that I've ever experienced, but I got to spend a day in a hammock reading a novel.... I have a hard life :)
I also go to zip line over a coffee plantation and then tour the plantation afterward. Did you know coffee comes from a red fruit that resembles a large grape and that 1 lb of beans = 1 plant? And that the lighter the brew of coffee the more caffeine? I guess the brewing process takes out caffeine rather than allowing more through. Oh the things I never knew! I loved the coffee there. Coffee in Guatemala doesn't have a bitter aftertaste. it was awesome. 
We also go to go see Mayan Ruins from the post-classic age, called Mixco Viejo with multiple temples. We had a Mayan Xamen accompany us and participated in a Mayan Ritual that blessed humanity. It was very... informative. I have to say that the Mayan people have earned my respect in many ways. I mean they were doing brain surgery while my people still believed the earth was flat. Granted the Mayans also believed that if a man cut his penis and bled into a fire a substantial amount he could breathe in the smoke and see the future, also maybe would pass out and be sterile for life but hey, why not? They also believed that jade was from heaven and shell was from the underworld and in order to wear jade you had to wear shell somewhere on your body. I never knew that there were different shades of jade and not all were green. I guess there is also black and lilac jade that are exclusive to guatemala. Google it, its really cool.
Other time off or spare moments we spent wandering Antigua, trying to look at the market and buying things. It was fun because their currency is called the Quetzal and you are expected to bargain... in Spanish. It was kinda fun to get good at it. Also to realize that 900 Quetzals in about $100 US Dollars.  Everything they sold was very bright colored with pretty cool designs. 

Overall, I loved the coffee, patients, and getting SO MUCH BETTER at Spanish the most. I got the most annoyed with being unable to flush toilet paper, the cold showers, and the excessive drinking that most of my fellow med students participated in during the trip. But it was so worth it.   And to get a tiny taste of this trip, here are a few pictures...






Wednesday, February 20, 2013

My Rank List

Rank lists were due today! So... about rank lists and matches. As I've already explained, the Match is a computer algorithm that will assign every medical student int he country their residency program based on a list we call the 'rank list' -- a numbered list of the student's preferences for residency in order. You can only list the programs that have interviewed you----  and the 'rank list' submitted by the programs of the students they have interviewed listed in numbered order.  The computer uses the lists to 'match' the student to the program. 

Since this is 2013, the D.O. match and the M.D. match are seperate still--- this is going to merge into one big match in 2015 (those LUCKY DUCKS!). Since we don't have that we have to chose between the matches because the D.O. match happens in feb and the M.D. match happens in march.

 Long complicated story short... after much deliberation I chose to drop out of the D.O. match. Ultimately, I applied to 60 ER programs got a total of 10 interviews.  5 DO and 5 MD.  (ironic no?)   When I looked at my list, my #1 & #2 are MD and after 4 years of med school i couldn't give up on a chance of getting them. They were just so much more my style than any other programs I saw, I made the decision to ditch the DO. Maybe this was a good decision maybe it wasn't. But I couldn't help but notice that in ER at least, the quality of the programs was just night and day. DO programs were just not as organized or polished and seemed to have less trauma. Obviously there are some exceptions. Anyhow, its what I did. For those wondering how I chose this list, its all about 'fit' and honestly I thought where would i be happiest? Where did the people seem like I would be friends with easiest? And maybe some about location, but mostly just where I fit best. So here is My Rank list....

  1. University of Mississippi in Jackson, MS
  2. John Peter Smith in Fort Worth, Tx
  3. University of Nebraska in Omaha, NE
  4. St. Francis in Peoria, IL
  5. St. Vincent in Toledo, OH
  6. Lehigh Valley in Allentown, PA  (this is dual program)
So on March 11th I will get an email that says either::  'matched'  or 'unmatched'   at this time if i'm matched I wait until March 15th when I get another email that says what program I matched to.

If i am unmatched, which is unfortuntely likely, since I really needed to rank 10 places to be assured of a match (ER is very competitive this year), I must enter the scramble (also called SOAP).  This involves me logging in to access the list of programs with spots after the match.  I then re apply using ERAS to 30 programs.  These programs I chose from will be in a variety of specialties and most likely will not be ER spots. Usually the unfilled spots is one of four: family med, internal med, psychiatry, and transitional year.  I chose not to enter transitional year because of funding cuts to Medicare (they pay residents salaries) they make it less likely for programs to want to pick up residents who already have been paid 1 year -- this will increase the chance that the hospital or program will have to pay the last year of the residents salary.  Anyhow, this was a really hard and crappy decision to make.  This boils down to meaning I may not end up being an ER doc like I wanted, but I am making this move so I can have some kind of paying job next year without having to go through this HELL another year.

So here's to my uncertain future and to March 11th, when I find out what kind of doctor i will end up being.....

(Edit: Before I forget I know 10 people personally who did not match in the DO match this year who ranked more than 8 places. Not looking good! Their specialities were: ER, Ob/GYN, Surgery. The NRMP reports that 10,000 med students won't match this year in the MD match. I'm getting freakin nervous!)

Wednesday, February 6, 2013

Guatemala!!!

Yeah. This is happening in Feb. I'm leaving tomorrow at like 3am.  So more later.