Tuesday, November 13, 2007

Endo/Repro Block, Round II

Yesterday was our first day of Endocrinology and Reproductive Biology (ERB). Evidently the ERB faculty have decided to follow the NMS pattern and give us two seminars per day. That would be fine--it would be great, actually--if they didn't also double the reading we're supposed to do! It's absolutely impossible to get it all done and still have time to eat, breathe, and sleep. I'm at about half done, half not so far this week.

Yesterday's seminars were on uterus pathology and pain during menstruation, and today's were on male hormones and menstrual disorders. So far they've all been well done on the whole. Our PBL case this week is good too. It's about an infertile couple, so there are a lot of potential problems in our differential. I really like my new PBL tutor. We're his first group, but he's a lot more involved than my tutor last block was, and yesterday's session went noticeably smoother versus last block. Today's FCM session was about improving performance measurements to increase the quality of health care systems, which has to be one of the least interesting topics I can possibly imagine. I know it's an important issue, and I understand why I should know something about it, but I can't say that I'm particularly fired up about which methods we can use to assess hospital performance.

My observed history and physical (H & P) was today, and it went really well. I had an hour and a half to get my patient's history and examine her while my preceptor sat in the corner and kept track of what I was doing. (This was a real patient, not a standardized patient.) The patient was really funny. When I went through the review of systems, she pretty much had every problem I asked about. She also was one of those patients who likes to go off on tangents, so I had to use a lot of closed-ended questions to keep her on track so I wouldn't run over time. There were a few things that I forgot to ask about (family history, illegal drug use) and do (listen for murmurs in the carotid arteries of the neck). But overall my preceptor was happy with how I did and gave me a really good eval. And this time, I did remember to examine both the heart and the liver from the patient's right side. :-) After the H & P, I had an hour to write it up and then 15 minutes to present it to my preceptor. I had to make a few corrections before submitting my final copy, and I'm done.

My take-home exam from the summer epidemiology class is due on Thursday, but I'm pretty much done with it. There was one question that I am pretty sure I got wrong, but I don't know how to fix it, and I am not allowed to ask anyone for help. Hopefully I'm at least on the right track, but at this point I am pretty much out of time and just need to turn it in.

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