february & 2009

I dated something the other day 2008, and afterwards told myself that we're well into February now. I think taking most of January to consider 2008 is about as far as I can stretch it, and besides, February is a good time to consider 2009. Because it's a packed month. This month is finishing my research project, the second year show, and planning the rest of the year because they kind of make you do that.

A year ago I was still writing the proposal for this project in Vietnam, and now I'm frantically writing everything up. The three main categories of findings are household consumptions (when confronted with health costs, what items on which households then spend less--including food, education, farming expenses), coping strategies (how do households without financial resources pay for healthcare--which we found to be mostly borrowing and a cycle of debt), and insurance (is the relatively new insurance system decreasing the economic burden of healthcare). It's been satisfying to put it all together, but it's also taking much more of my time than I'd like. Mostly, while public health as a concept is essential, I'm still averse to the need for research and theory to prove it.

Just as I can't believe it was one year ago that we started this project, I can't believe it's been one year since last year's second year show. The second year show is a string of skits, dances and videos that make fun of our faculty, traditions, phrases, and other Yale Med specific quirks. It's a nice thing to do as an entire class, reminiscent of our high school spirit weeks. It means setting up and practices and such, over the next couple of weeks. So it's an event to anticipate and to overwhelm (us).

So that's February in its active form. The part that lurks is the planning part. 2009 is split into halves: the Boards and the Wards, both of which are punctuated by travel. These things bring to mind some of the new vocabulary I've learned in med school that I hate. They will come up as I go.

The Boards consists of three steps, all required to attain a medical license. I'll be taking Step 1, the most important of the three, at the end of May. Step 1 is a 7-hour exam with 350 multiple choice questions that tests everything we've learned (and haven't learned) for the past two years. Off the top of my head, that includes biochemistry, anatomy, stats, immunology, microbiology, pharmacology and most importantly, physiology and pathology of all organ systems. Med word I hate #1: high yield. This refers to bytes of knowledge that will likely appear on an exam, things that will give you the most bang for your study time. I know it's realistic to think in terms of yield, but I also think that sometimes medicine is too entrenched in the approach of thinking about what gives you the absolute most. I know waste is not good, and I don't have a rational logic for why this would bother me except that perhaps the measurement of what has value is so regimented.

The reason this is the most important Step is because it's the main factor in applying for residencies after med school. If you want to go into something competitive, it matters a lot, and it matters a lot to most of my class. Med word I hate #2: gunner. Gunners themselves don't bug me that much as long as they don't shortchange other people to get ahead, but it is a little bothersome that the general impression of our culture is that we're all gunning for...something? At this point nothing I'm interested in is competitive (apparently 2% of graduating med students go into primary care these days), but who knows what I might end up enjoying, and I would like to pass. More than that, I would like to feel that I'm doing relatively well in what I'm consuming my life with, and I would like to know things.

The latter part is why I'm looking forward to going home to study. We get six weeks off school to study, and by studying, they mean something like ten hours a day, six days of the week. Though I doubt both my ability to study for that long and that the amount of time's sufficient to learn everything, I look forward to a routine of learning. I look forward to morning runs in Fremont, a consistent study schedule, meals at home, quiet nights and the one day a week of nothingness. It might sound sad to compartmentalize a month and a half of your life to not really living, but I'm in school to learn these things and I haven't done a great job of it thus far, so I'll be glad for an excuse to try.

Besides, afterwards comes the punctuated travel, to Prague!

Then comes the rest of June and the second half of 2009, the Wards. The wards are when we enter as the lowest rung in the hospital. We "rotate" to different areas of medicine, like ob-gyn, surgery, pediatrics, and so on. So we leave behind the realm of no responsibility and re-discover on a whole new level how little we know. Med word I hate #3: pimping. This means being drilled by your superiors in the hospital, and in my case 99% of the time, not knowing the answer. I'm very much looking forward to patients and active learning and doing the history and physical exam for the patient's sake instead of ours, but I'm not looking forward to being pimped, thanks.

But after the beginnings of that comes a month off (December), half of which will be spent lovingly at home and half of which will be spent in travel to somewhere to be decided!

In any case 2009 is a hefty year. I'm not ready but I think I will remember to write 2009 from now on.