Monday, March 9, 2015

Gearing up for Family Med exam, and some thoughts

There is less time for crafting and the like as I gear up my studying for the end-of-service exam for Family Med. This exam is notorious for being all-encompassing, and  it pulls questions from pyschiatry, pediatrics, and OB/GYN, as befitting the scope of the field. This means it is a much bigger pain to study for than other exams, like surgery or any of the above mentioned fields. It is also more pressure on me to do well on this exam, as it is one of the fields I am considering entering, and I want to make sure I don't fail this exam!

Here are some notes about knitting, and the rest will be thoughts on Family Med clinic encounters.

<Knitting notes>

I finished my shawl! It's the Balsam Hollow shawl from the Little Skein in the Big Wool Anne of Green Gables kit, with Leading Men Fiber Arts yarn in the Anne with an E colorway. It was actually a quick knit, everything considering. My dad had a slight medical mishap last week, so I sat in the quick care waiting room with him and got a LOT of knitting done. I was so happy to finish it, and just in time for our unusually cold Sunday morning hike!

I am using the rest of the yarn to make a matching hat. More on that in the next post!

I also bought several tincanknits books during their BOGO sale last week, and I'm getting ready to cast on a gramps cardigan for a friend's new baby out of Tink yarn.

<end knitting notes here!>

On a different thought, we encountered a patient this past week who presented with a spotty past medical history, and stated that she was anemic and instructed to take iron pills. Being a medical student, I wanted to investigate her anemia further, when the preceptor asked her why she had been anemic, and the patient stated that she had only recently had a job, and before that, she she didn't really have money for food. I was a bit taken aback, as the clinic where I am working this month is in one of the wealthiest areas in the city, in the same mile block as Whole Foods and several high-end yoga studios. The family medicine book that I was reading about anemias actually stated that "all adults in the US are unlikely to have nutritional deficiency-derived anemia" and to "rule this out as a possible cause." But in this day and age, when the American economy is still slowly recovering, and some (like my patient), are only working part-time for minimum wage, they are unable to afford good nutrition, it is still possible in America to be nutritionally deficient. In the age of cheap fast food, they'd be able to meet the daily caloric requirements, but most likely it is not nutritional in nature. It is sobering to encounter first-hand that there really is still poverty and hunger in America, the Land of Plenty. 

I saw three patients this week that made me nervous and thoughtful at the same time. Two of them were a couple, who came on separate conditions, and were both physicians nearing retirement who recently move to the area. The husband was the new director of one of the largest healthcare programs in the area. The third patient was a nurse, one who manages eight different clinics. I was shaking as I conducted my H&P. I wanted to be thorough and do a good job, yet I didn't want to make any mistakes or go too slowly. I didn't know if they might be judging my clinical abilities. I was happy that they were nice and let me conduct my exam, but I was definitely afraid and extremely nervous. On the same hand, it was also somewhat sobering and thought-provoking, that these "important" people of the healthcare industry were given the same medical care and treatment as those who could not afford to eat dinner properly. Medicine truly is the great equalizer, especially in America.

As I finish my second month of Family Med, I am truly humbled by the amount of knowledge I have gained in the last two months, from my preceptors and my patients. I have been so lucky to be able to have so much access to knowledge and medical information and patients, and I am so thankful to the patients for being patient with me as I fumbled to do their history and physicals. Family medicine has been the most stressful and most fun rotation. Now, on to OMM month!