Tuesday, April 10, 2007

FCM, Two Hormone Seminars, and Observed H & P

Today's FCM session was actually useful, although it wasn't particularly interesting. Our reading was about HMOs, PPOs, insurance, capitation, and other such topics that numb the mind of the average medical student, but are still incredibly important to understand. I won't bore you with explaining any of them. If you don't have to know what any of these things are, consider yourself lucky and never think of them again. If you're planning to go to med school, well, you'll have to learn about them once you get here. Sorry.

Our seminars were on the regulation of metabolism and appetite. I don't have any complaints about the seminars themselves. Both were case-based and fairly interactive. But at risk of repeating myself, we were once again crammed in like sardines in these stupid conference rooms that are way too small for half our class. Also, I wish the course directors would realize that just because we have double the number of seminars does not mean that we should have double the amount of reading to do. As it turns out, I have been invited to sit on the feedback meeting for this block on May 3, so I'll have a chance to tell them again. I've already been telling them every time I see them and every Friday on our weekly feedback forms. Hopefully it will help for next year.

This afternoon, I had my second clinical exam. (The first was the OSCE that we took before break.) All in all, it wasn't too bad, except that I had to rush right over to the clinic after seminar because my preceptor asked me to start at noon instead of 1 PM like usual. This meant that I didn't get a lunch break, but it was fine because I ate lunch during the second seminar. As it turned out, I was eating during the appetite regulation seminar, and the seminar leader used me to illustrate his learning objectives. I didn't tell him that the real reason I was eating during his seminar was because I had to go straight to clinic afterward. How could I tell him that after he had worked so hard to explain my early lunch time based upon my appetite hormone levels?

This exam was an observed history and physical (H & P) of an actual patient. We were basically supposed to do the entire H & P, everything that we've learned up to this point. Your preceptor is in the room with you during the exam to observe with a skills checklist, similar to the OSCE. This patient was just there for a checkup, and my preceptor wanted me to discuss smoking cessation with her. I did counsel her about it, and she agreed to work with the doctor to set up a plan to quit. We picked a quit date for her too. Hopefully she'll stick with it. The exam itself was pretty unremarkable other than being two hours long. It definitely wasn't very stressful. I had my list of systems review questions and exams, but my preceptor had me skip some of the exams in the interest of time. My feedback asked me to work on memorizing all of the exams and questions because this would help me speed up the exam. Well, I guess if the worst thing my preceptor can say is that I am too slow at performing the exam, that's not the end of the world. My preceptor is super nice and encouraging though. I am planning to keep coming to the clinic over the summer to get more experience with examining patients.

At the end of the two hours, we had another hour to prepare an oral presentation to give to our preceptors. We also have to turn in a written H & P. It isn't due until next week, but I figured I'd go ahead and do it now while I still remember everything. This H & P is much longer and more involved than the one we did on tape a few months ago. My preceptor made me re-write it a few times because I left some stuff out, but now it's done.

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