Friday, September 19, 2014

Mainahs Love a Wicked Good time.

Hello Everyone! It looks like it has been over a year since my last post. During school, I get very busy studying and posting gets placed on the back burner. I am off the island of St Kitts now and have already moved to and from Portland, Maine and back to Iowa again. I wanted to do a post about Portland though to give you a little idea of how it works up there.




I was able to spend May-Aug in Maine. Maine is a beautiful state and reminds me a lot of Minnesota. I wish I would have been able to go up north to see more of the state but I really enjoyed being by the ocean (one thing I was very spoiled by in the caribbean). Boston is just a 2 hr drive away and NYC about 4 1/2. I took quite a few road trips to both cities. For anyone that has never been to Boston/Maine before, the accents just cracked me up. Pahk the cahr ovah theya. (Park the car over there) :)
Boston
NYC

As far as school goes, we spend 4 months at our Portland, Maine location mostly getting hands on experience as well as completing a Kaplan test prep course. The first 8 wks of the semester goes as follows:
Monday: Receive lecture on organ system (cardio, resp, MSK etc) + occasional extra lectures
Tuesday: Virtual Clinic for 1 hr and Clinical Skills Lab (Choice of Tues or Wed)
Wednesday: Sample Cases for Organ System and Clinical Skills Lab
Thursday: Preceptor or if not in one Break!
Friday: Preceptor or Break!
*There are 2 exams (besides the entrance and exit) given over the organ systems we have studied. One at the 4 wk mark and one at the 8wk mark.


Preceptor
You are assigned a preceptor in which you go weekly either the 1st 4 wks or the 2nd 4 wks of the semester. I was placed with a Pediatrician the first 4 weeks. From what I've heard from other students, I believe it is best to get your preceptor the 1st 4 instead of the 2nd 4. Towards the 2nd part, things get a little more busy and it can be a bit harder to reschedule missed times.

I had an excellent experience with my Pediatrician. He allowed me to go into the room with the patient and complete a full history as well as a limited physical exam. I would then go discuss with him what I had talked about and then he would review some things with me and we would go back into the room together. Prior to this experience, I didn't have a lot of experience in pediatrics and this allows me to change my thinking a little because the style and type of questions you ask are very different in a pediatric setting vs an adult setting.


Virtual Clinic
Virtual Clinic was my favorite part of Maine. The school has 8 exam rooms each with a fake patient (an actor) as well as either a retired or currently practicing physician. You are paired with another student doctor and both of you enter the assigned room. One of you is the Doctor and the other is the presenter. The presenter sits in the corner and writes everything down as the doctor asks the patient for a complete history and then does whatever physical exam is necessary. During the physical exam, the doctor will provide necessary lung and heart sounds needed for your diagnosis as the patients are healthy and you won't actually hear anything abnormal. After completing the exam, you are required to come up with a list of differential diagnoses you think the patient might have, as well as tests you would like to run. You will then council and suggest necessary treatment. This was the most difficult part, as you didn't have time to walk out of the room and collect your thoughts, you had to come up with everything right on the spot without notes. After you have completed, the other student doctor can ask any additional questions or perform any additional parts of the physical exam he/her thought were necessary. They then present the case and then can either agree or disagree with the prior diagnosis made by the other student. When finished, the Doctor in charge of the room discusses the case with both students and gives feedback. 

Clinical Skills Lab
We had clinical skills lab every week either on tuesday or wednesday. We learned how to insert IVs, draw blood, intubate, give injections etc. Everything was done on fake arms but it allows us to practice these skills.


Learning to intubate!

Kaplan
A 6wk kaplan review course is offered with live professors. It includes classes from 8-4ish almost everyday. You have a break in between each section such as biochem and micro but somedays your break is a monday some days a saturday etc (and yes we went on weekends as well.) Class was good, but long as you can imagine. Sitting in one location all day listening to someone else talk is not the easiest. I can't say I enjoyed all of the Kaplan professors but some I did and learned a lot from. Not only do you have the live classes but you have access to the qbank with over 2500 questions and online lectures. 

The very first day of class, back in May, we had to take an entrance exam. This was a 8 hr, 322 question exam just like the USMLE Step 1. This exam is not counted as part of a grade but I did not study for it, instead I wanted to use it as a baseline and see how much from the basic sciences I remembered. You received your score when you finished which is a percentage and it gives you about what number you would score on Step 1. I passed which was a good starting point! At week 8 of the semester, they offer another kaplan full length exam that is optional. I improved from my first to my second but not as much as I had hoped. Then the very last day of the semester, wk 16, we took a 4 hr NBME exam. Our semester we took an NBME but I think now they switched it back to another kaplan exam.

Exit NBME
The exit is the most important test of the Maine semester. You must pass (whatever the school makes a "passing" grade as) in order to register for the USMLE Step 1. The school does this because they want to make sure that you will pass the exam that matters, Step 1. As I said before, this is a 4 hr exam. You receive your score about a week later. If you do not pass, you are required to take it again and are given 3 tries to do so. Good news was I PASSED the first time! :)

Well that was a little about semester/ adventures in Maine. I will be writing another post soon regarding my preparation for the USMLE.

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