Transitioning to the Clinical Years

April 21, 2014

Happy Monday all! Thanks again so much for all of your post ideas! For today's Med School Monday I thought I'd do a quick post on a situation many of you are facing now - heading to the wards! The transition from the classroom to the clinic/hospital is a big one, but for most of us, it's what we've been waiting for all along! Finally being able to help care for patients, or get into the O.R. and do some surgery, or deliver babies, it's what we signed up for! This post will provide a few simple tips to succeed on the wards. Ask any question you have in the comments section below!

The Basics

  • You are a student. If you knew all of this stuff you wouldn't be there in the first place. Remember that. But you are a smart student, and you can learn quickly. Ask for expectations from the get go because not all "teachers" are the best at telling you, and learn how to meet those expectations quickly. (Ask whoever is your overseer, whether it be the intern, resident or attending, or all of them as they all have different expectations. A good way to find out is simply to ask (hopefully on day one), "what role do medical students usually play on your team?" Or, "how can I best help the team?")
  • Be an anthropologist. I was told this and I always thought it sounded so corny. But it is so true. Those who succeed on rotations are those who are able to observe how the locals act and quickly fit in. The hardest part about third year is that you're on psychiatry one month and as soon as you feel like you actually know what you're doing, BAM!, you're on surgery feeling like an idiot again! And this happens over and over again. So follow the first point, and do your best to be a local! Most interns keep a checklist of all the tasks that need to be completed, start keeping a checklist too and help where you can (communicating with the team, of course). 
  • (Almost) nothing is below you. Although you are a student, and you are paying to be there, nothing is more annoying than someone on a team who acts like they're paying to be there. Help out as best you can, whether that means undressing wounds before early morning surgery rounds, carrying around extra supplies (including a stethoscope - your attending will need to borrow it more than you expect!), calling family, or putting notes in charts. With that said, there may be some things that seem unfair, and you just need to use your better judgement about speaking up - if everyone on your team rotates to pick up coffee and it happens to be your turn - get coffee! If you're missing out on the action because you're always the one asked to get coffee - we've got a problem, and you should find the right person to speak to about it. Sounds basic but you'd be surprised how many people seem to be lacking common sense when it comes to this stuff.
  • Get to know the nurses. Again, this will change as you move from rotation to rotation, but please do yourself a favor and get in good with the nurses. Nothing bothered me more than working with a med student who thought they knew more than the nurses. In the OR, they can make you or break you, and on the wards, they can help with patient information that no one else on the team will know! I love rounds that include the nurses, but not all of them do, so make sure to get info from them daily! I've had nurses get on their knees with me and help change a VAC (a disgusting task you will likely learn if you do a vascular surgery rotation), nurses help me with suturing before anyone showed me how, nurses page me when family comes by so I could catch them and speak with them, and my last team of nurses that threw me a baby shower for Liv!

On Studying

  • Say goodbye to huge textbooks (well, more like see you later). While you're actually on the wards, the best way to study is to learn from your patients and those your team is taking care of. UpToDate is quite possibly the best resource for clinical care and hopefully your institution has access to it (if not, find out what source your residents are using and use that). If you have time to read in advance before seeing a patient, read the article on their presentation. If you don't have time, make sure to read it that night when you get home. If you're on OB and your patient came in with hypertension, read about hypertension in obstetrics and the differential diagnosis and wherever it leads you (likely pre-eclampsia). There are of course plenty of books for the wards people will recommend and I'll do a post later on that, but learning this way really is the best way!
  • Learn from your team. If you feel comfortable (and if it seems like it's ok to ask), when there's downtime (ie, don't ask in the middle of rounds or when there's a code) ask why the resident chose the antibiotic course they did, or how they came to their diagnosis. Make sure to not come off as asking in a challenging way, but more for your knowledge, (most) residents love to teach when they have the time. If you feel more comfortable talking to the intern or the attending, ask them! 


On Dressing

  • Scrubs are friends. Wearing scrubs doesn't mean you have to look like a scrub though, and staying well-groomed definitely makes you seem more put together and professional. Comfy shoes are a must with scrubs and I highly recommend Danskos or closed Crocs (I lived in this pair third year).
  • For clinics or times you're not wearing scrubs, keep it professional. Check out past Work It Wednesdays for some inspiration! (I'll be heading back to the hospital in June so I'll be posting more inspo then)! And keep your white coat clean! A little bit of OxiClean works magic!

At the end of the day, the main goals are to LEARN and HELP. It's a balance, but it can be done. Make sure to smile everyday and not beat yourself up for not knowing something or slipping up on your presentation. Get better everyday and you will be an all-star. 


Happy Easter!

April 18, 2014

I seriously love when Isabel visits to take pictures of Liv. She travels with her studio and sets up right in your apartment and captures your heart on camera (ie, your little one). The one difficulty, as any of you parents know, is baby couldn't care less who's coming to visit. Take Liv on this gorgeous day for example. She would not nap, and when Isabel came, would not smile! My giggly girl would barely crack a grin! But it's ok. Because what we caught on camera was something just as awesome - Liv discovering something. What you have here, folks, is Liv discovering an easter egg. First she grabs it in disbelief, marvels at the wonder that she actually has in her hands, and then - the final and most definitive mode of discovery - she must taste it. Everything goes straight into the mouth with this one! 

I hope you all have wonderful Easter holidays if you celebrate and found some joy in Liv's 6 month pictures!


Spring Mom Uniform

April 16, 2014

I seriously lived in this outfit the last two weeks. The comfiest jeans that practically feel like sweats, an easy tank for nursing, a soft denim shirt, nude sandals, and big shades. Mom or not this look is too easy not to repeat over and over again. 

And thank you so much for all the post suggestions in the last post! Professional/business chic outfits will definitely be making a comeback very soon - I head back to clinical/hospital rotations in June so no more jeans to work for this girl! Would love to hear any more suggestions in the comments section!


Weekend: The Big 1-5

April 14, 2014


Happy Monday all! Just wanted to share a few pics from the wonderful weekend we had back home celebrating my little sister's 15th birthday. It's a big deal in hispanic culture, we threw a huge QuinceaƱera complete with the big white ball gown, damas and chambelanes, limo, etc. etc. etc.! Crazy that my own QuinceaƱera was now over a decade ago and all the cousins I used to babysit for are now finishing high school and in college. Liv had a blast seeing all of our family and partied the night away, even slept in her little white dress! Sunday we had a lazy day and a big brunch before hopping back on the road. I hope you all had great weekends!! Also - make sure to leave any ideas you have for posts in the comments section! Would love to hear! 

Babywearing: Carrier Comparison

April 11, 2014

I've professed my love for babywearing over and over on this blog (and you've seen it on my Instagram) - and boy am I reminded of how great it really is when I have to push my huge stroller through the busy streets of Cambridge and its little shops (let's just say I gave up and set up camp at Panera that day instead lol). 

With babywearing I can carry Liv with me everywhere I go and not feel limited to places with wheelchair access or wide aisles or double doors, and I have my hands free to sip an iced coffee or just rub her back and roam together as I so frequently do. But this post isn't to convince you all to become babywearers - it's for the many of you who are already convinced and just looking for the right carrier. I've used different carriers during Liv's first 6 and a half months of life, so I figured I'd review the pros and cons of each with you here and hope that it can help in your decision of which type of carrier is right for you and your little one! 

The carriers I've used are the Solly Baby Wrap, the Ergo Baby Carrier, and the Sakura Bloom Sling (the single layer linen). I'll compare them by the features I think are most important in a baby carrier, but as always ask any questions you have in the comments below!


Comfort
A big part of comfort depends on the size of the baby you're carrying. I'd say for long periods of time (ie walking for hours and hours), the Ergo has proven to be the most comfortable regardless of how big Liv was. The straps are nice and cushinoned and there's lots of support for your lower back - somehow the weight of the baby is really evenly distributed so you don't feel it in any particular area at the end of the day. The Solly Baby was pretty comfortable for good chunks of time when Liv was smaller, but around the 4 month point it wasn't as comfortable (mind you Liv was in the 70+ percentiles for everything so she's a bit on the larger side). The Sakura Bloom isn't the best for very long periods of time. Because most of the weight is focused on one side or the other, you can start to "feel it" after a few hours (but I got through traveling and day trips with Liv at 6 months without much of a problem, we're not talking back pain or anything, just not as comfy as the Ergo). Although please do note, I have the single layer "pure" style, and the double layer is supposed to provide more support. 

Versatility
The Sakura Bloom wins here. I love the hip carry (and so does Liv right now), but you can do tummy-to-tummy, cradle, facing out (kangaroo), on your back, etc! Lots of different positions to try. The Ergo also has the option for back carrying (and supposedly hip carry, but I tried and all the straps get a little confusing), and the Solly Baby is pretty much just facing you. 

Adjustability
I bought all 3 of these with the idea that N could wear Liv too, which he absolutely loves. So all 3 are adjustable and fit the both of us. I'd say the Sakura Bloom is the easiest to adjust, especially with baby on - just pull the fabric on one side or the other - it's perfect in its simplicity. The Ergo has a few more places to pull but it can also be adjusted easily, although sometimes I have to ask N for help if I've already got Liv in it (most of the straps are behind me). The Solly Baby can't be adjusted with the baby on, and if you need to adjust it you need to take her out and re-wrap the whole thing. Better to get it right the first time (I always just tied it tightly to me as the fabric stretches a little with baby's weight anyway).

Ability to Nurse on the Go
The Ergo and Sakura Bloom are wonderful for nursing on the go. This is probably my favorite feature of babywearing. Liv will just tuck her little head in and can nurse as I walk down the street (we actually do this) - and with the Ergo I can cover her head with the hood while with the Sakura Bloom I can just pull up the sling a little bit or cover her with the fabric tail of the sling. I never figured out how to nurse with the Solly Baby, which could be more of a failure on my part, but it just never worked out. The inability to adjust it with the baby on definitely could contribute too. 

Portability
Sometimes you just want to toss the carrier in the diaper bag for if you need it later, or take baby out for some playtime and put the carrier somewhere until you need it again (like we did on our recent flight). A compact stow-away size is definitely a plus. The Solly Baby with its light jersey fabric is definitely the smallest when rolled up completely, the Sakura Bloom follows close behind, and the Ergo is definitely the bulkiest. See the picture for the comparison (I didn't roll up the Solly Baby as tight as it could go, it can be a little smaller than this). 


Look
This part is all a matter of personal preference, but as far as "style" I always thought the Solly Baby and Sakura Bloom were just so beautiful. Absolutely beautiful. Look through any of the instagram feeds of these brands and you'll see what I mean. I love them both for that. The Ergo isn't the prettiest, especially with the bulky straps (what makes it so comfy), but with a light layer on top I never found it to be an issue. 

Carrier Care 
I have yet to wash any of my carriers, but Liv has definitely thrown up on all of them. They all have been very easy to clean with a wet towel. Any mommas have experience actually throwing these in the washing machine? Would love to hear below. 

Cost
Ergo Baby - $115 on Amazon.

Sakura Bloom - $88 for linen pure (single layer), $148 for linen simple (double layer); more options like silk and two-tone available on their website.

Solly Baby - $65 on their website.

I hope this post can help some of you babywearers figure out what's best for you! At the end of the day I love all three for the simple fact that they keep Liv close, and they're all great for different occasions and different tastes! 

I'll keep you safe, you keep me wild

April 8, 2014




It's absolutely mind blowing to me to think that this time last year N and I were taking photos of my barely there baby bump... now we're taking family photos at the same very spot. Not to mention I got home from work last night and Liv started crawling! Check out the video on my instagram here. And so it begins! This custom print from Brim Papery couldn't be more perfect for the relationship I feel with Liv right now - "I'll keep you safe, you keep me wild." Seriously, never have I laughed out loud more or made ridiculous funny faces on the T or sang and danced in the park and not give a damn about what anyone thinks except for my baby girl who's growing like a wildflower before my very eyes.  

What to Major in

April 7, 2014

Hello and happy Monday everyone!! I hope you all had wonderful weekends, the weather finally started to feel a bit like spring here so we spent lots of time outdoors. For today's Med School Monday post I wanted to quickly address a question I get from a lot of my readers who are in the early years of college or the college application process: what to major in [for medical school]. So here's a little about that!

I'll say first off - I majored in Neuroscience and minored in the History of Science and Technology. I absolutely loved neuroscience and history has always been my passion, so I didn't do these for med school, I did it because I loved studying it. {Quick super nerdy fact about me? I have a tattoo of the first time the word brain was written in human history - it's hieroglyphics from the Edwin Smith surgical papyrus and dates back to around 1500 BC}. I share this because I truly think college is a time you should study what you love and what you're curious about. I was lucky enough to go to a liberal arts college so I really did explore lots before declaring my major sophomore year - taking courses in African American Women's History, Anthropology, Archaeology, Philosophy, I loved it all.

Now for medical school, there are courses that you have to take. At most colleges there's no "pre-med" major, and if there was you probably shouldn't major it in anyway. Just get through these pre-requisites (which are slightly different for each medical school, so make sure you check the website of schools you're interested in), but they are generally something like this: 2 semesters of biology, 2 semesters of physics, 2 semesters of inorganic chemistry, 2 semesters of organic chemistry, and 2 semesters of english.

These classes are all important to do well on the MCAT, which you will have to take for admission to medical school. The grades from these classes will of course also matter, but they're meant to prepare you for the test and be a foundation of what you will later learn in medical school. Did I have friends who were physics majors and did better on the physics portion of the exam because of that? Yes, but only by a couple of points if that. The same way I had friends who did better in bio because of being bio majors - the point is that these differences are minor, and I think you'll get a lot more from majoring in what you truly are interested in rather than physics just for a point or two on an exam.

Do keep in mind that GPA matters. If you love English but are horrible at writing papers and can't get good grades in those English classes, maybe English isn't the major for you. On the other hand, if you're just majoring in Bio because it comes easily to you and because it fulfills lots of the med school prereqs, you're sort of cheating yourself out of a great education. This could be your last time to study history or government or Italian - there will be plenty of time to study science in medical school.

Some examples of undergrad majors my from my classmates here at Harvard include Philosophy, Psychology, Biology, Anthropology, Engineering (of all varieties), Neuroscience, and Economics.

I hope some of you can find this helpful, and as always, leave comments about your opinions or ideas for posts or anything! And if you've sent me a comment don't worry - I got it! I'm making my way through responding to those during the little "downtime" I have haha. 
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