Which one am I?

I think this is fitting, since for some reason I've been thinking more lately about what specialty I want to pursue once medical school is finally over (if that ever happens...) Which category am I in?



From Movin' Meat

What have I gotten myself into?

I die a little bit inside every time I see doctor bloggers complain that the 80 hour per week limit for residents is not enough time for them to learn everything.

Is is just me, or does 80 hours a week seem like too many hours already? I mean, I can see that 40 hours is really not a lot, so I'm okay with more than that. Plus, I understand that in residency, they push to get more experience in in a shorter time. And I know there is a LOT to learn, so it takes time to learn it all.

But hearing about what's coming at a time when I feel like I am already spending every waking minute studying or thinking about how I should be studying, makes me feel like the next 6 years of my life are going to be more of the same.

I guess it's good that I'm teaching myself to like coffee now, because it looks like I'm going to need it...

First post! (for me)

This is my first post here, so I figure I should probably introduce myself. I'm Abby's sister, Dr. Liz ... except, I'm a Doctor of Pharmacy, versus being a medical doctor. I work in the retail setting (at a store I'm going to be referring to as Rx's R Us ... and, of course, all patient names and identifying information will be changed for patient privacy reasons), and I graduated from college a few years ago. I've been working in pharmacy, though, for a half-dozen years or so by now, though, so I definitely have plenty of stories to share. I generally won't bore you with old stories, but if something interesting happens at work, I'll definitely pass it along.

And, it just so happens that I have a story about a "special" patient of mine to pass along.

Last night, a patient calls in a refill for her Diazepam 10mg. Directions: 1 tablet three times daily. She received 90 pills 10 days ago. I flag it as being too soon to fill, and call the patient to tell them that I will not have it ready for them that evening. The doctor's office is closed, so I can't check about getting an early refill.

But, wait, it gets better.

The patient proceeds to tell me that she talked to the nurse, and the nurse said that she was going to call in a new script with the right directions. And what directions were these, you might ask? 30mg of Diazepam three times daily. Because the patient was in so much pain, that's how the doctor told her to take it. (my mental response: riiiiiiiiiiiiiight)

I tell the patient that I don't have any way to get ahold of the doctor, but they're willing to try if they'd like to do so. I say that I cannot fill the prescription until I hear back from the doctor giving me new directions and/or an authorization to fill the medication early.

This morning, I call over to the doctor's office - they do a lot of orthopedic stuff and deal with a lot of patients in pain, but I'm pretty sure that the nurse will not be confirming the patient's story.

RPh: Patient Susie Smith --

Nurse: *audible sigh*

RPh: I take it you talked to her this morning?

Nurse: Last night, actually. She called to have the doctor call in a new presciption for her Valium (brand name for Diazepam), saying that she's had to take more of the medication because of her pain. I told her last night that the doctor was already gone when she called in, so it would have to wait until today. He won't be in until after lunch since he's in surgery this morning.

The nurse said she'd call back once she talked to the doctor about the patient, but I didn't hear anything back before I left work this afternoon.

And, to top things off, the patient finally realized that I wasn't going to fill her RX without doctor authorization (which didn't appear to be forthcoming), so she had the prescription filled at a different pharmacy. I told the other RPh about the too soon issue, but it's their problem now ...

One of these things is not like the other...

Many time since I've started medical school, I've gotten the feeling that I don't quite fit in. I don't mean that in a whiny, "nobody likes me" way, just that in the course of typical medical school activities, I sometimes realize a new way that I am different than the my classmates. There are lots of these examples, but this post is about one that happened today, in one of the million small group sessions we have for our Respiratory course.

I forget why, but for some reason the conversation landed on "back-up plans", what we would do if medical school didn't work out. I don't think any of us are actually expecting to need these, but it's kind of nice to fantasize about an alternate life when the pressure of medical school gets too high. But after today, I'm starting to think that I need to get a new back up plan...

The other people in my group had back up plans like "wedding planner" or "librarian". Guess what mine is: Pharmacist. No, seriously, it is, and I tell people that all the time. Way less time in school than medical school, but killer compensation when you are done. (Not that I'm in it for the money, but still.)

What does it say about me that my back up is so similar to my current plan? Obviously, the fact that I have a sister who's a pharmacist has something to do with it, I think, but I can't even think of a non-medical fallback career I'd be interested in. I think I need to work on that...maybe alpaca farmer? (Come to think of it, I do think that would be a pretty sweet gig. They're so cute!)

New world order

I think one of the hardest things about medical school (besides, you know, being really hard work) is that the standards of measurement change so drastically. Medical students all come from a background of academic success; otherwise we wouldn't have gotten into medical school in the first place. But once you are actually IN medical school, it's just not possible for all of us overachievers to keep being the best.

So it's been an adjustment to try to be satisfied with managing to be merely average, and trying to be happy with "above average" when that means an 86%, when the average was 84%. I told myself this year that (after pass/fail grading last year), I wasn't going to get caught up in always trying to be the best; I was going to try to be reasonable with my expectations. But I don't think it's worked. Maybe the worst thing is that I feel like I spend every waking moment studying, but it's still not enough. I'm not really sure what I could have done that would have pushed that 86% up to the 88% it would have taken to get an A in CV (which has a massive curve, if you couldn't guess).

But I felt this way last year, too, especially at the beginning. So, I'm still holding out hope, that as I get used to the new rhythm, I'll inch closer to the top of the heap. But, really, in a class of all stars, middle of the heap's probably not so bad.

After all, what is it they say? "What do you call the person who graduates last from medical school? Doctor. " One day, I'm sure, I won't care what grades I got, but right now, it hurts a little not to be the best.