Med School Update: Second Didactic Week

Six rotations down, six more to go! We had two of our student friends come to stay with us again. We love having them, and Scott especially loves laughing at their medical jokes and talking sports with them. He was really looking forward to when he could play basketball with his classmates, but he had a foot injury, so he had to avoid the games.

Even though it seems like basketball or football are the main events, the third years were really in town  for didactic week exams.

The night they arrived they each practiced doing patient interviews on each other covering topics in the areas that they rotated through. Then the first two days the students had a review meeting and patient encounters. The third day their was a meeting with the dean and the students took tests on the rotation areas they just completed. The scores from those exams are recorded on the students record and are viewable by residencies. The last two days of didactic week included planning sessions for the upcoming block of rotations. Scott has two internal medicine rotations and psych coming up next block.

We ended the week with our last annual medical school friends ugly sweater party... complete with an opportunity to give stitches to one of the kids. Goodness! Merry Christmas, friends!

Booking a Caribbean Cruise

Last month I took a cruise with my husband to celebrate my upcoming 30th birthday (yes, we still look like we're 16).

The cruise came after several months of dreaming, researching, and planning. While I thoroughly enjoyed our relaxing vacation, I have learned a few things about planning a Caribbean cruise that I want to remember.

1) Keep in mind when booking a cruise departing from Port Canaveral, FL that there may be additional costs compared to cruising from a port closer to the airport. In order to cruise from Port Canaveral, Scott and I flew into Orlando and had the option of finding unreliable shuttles, reserving a rental car and worrying about on-time flights, or booking a $70 round-trip cruiseline shuttle. I ended up finding two one-way car rentals for less than $70 and luckily our cross-country, winter flight arrived on time.

2) If you book early, most cruiselines or travel agents can match to a lower price if your room rate drops before your cruise. Since we booked the cruise this last spring, we were lucky to get an additional discount on the room before our final payment was due 90 days before the cruise. I love saving money!

3) Speaking of saving money, remember that you will have on-board charges during your cruise including gratuities. Each cruise line will have different suggested gratuities for your housekeeping and dining room staff. Royal Caribbean has a set gratuity amount charged to your room per person, per day ($12). When we booked our cruise, the travel agent gave us $100 shipboard credit as part of our deal. Because I did not pay my gratuities in advance (My Time Dining requires prepayment), the shipboard credit was applied to my gratuities. Don't forget to factor in your on-board charges and excursions when budgeting for your cruise.

4) Book a balcony. The extra space is worth it and qualifies breakfast in bed as an excursion.

5) I would absolutely recommend Royal Caribbean as a cruise line, no matter the location. Our housekeeping and dining room staff were extremely friendly and went out of their way to help us have a great time. I was also impressed with the integrity of staff members. We forgot our iPad in one of the restaurants and they were preparing to return it to us when we finally remembered where we forgot it.

Our ship was very family friendly as well. There were many family activities, including games and shows. Many of the movies shown on the ship were family films. Kids activities included DreamWorks  character visits and parades. The cruise directors did a fantastic job scheduling a variety of activities all throughout the day, especially on sailing days.

6)When choosing our cruise, I looked at what ammenities the ship had and specifically chose a ship that had the FlowRider. I thought my husband would want to try it out. While on board he was too intimidated to try, and there were plenty of other activities on board to keep us busy. We did use the miniature golf course, basketball court, and rock climbing wall. We enjoyed the jacuzzis around the pool deck, but didn't use the swimming pools. The kids play zone on the pool deck looked like a great splash pad for kids on sunny sailing days.

7) We absolutely loved our Eastern Caribbean cruise. We stopped in St. Maartin and St. Thomas, in addition to stopping at Royal Caribbean's private island CoCo Cay. However, if I were to schedule another cruise today I wouldn't schedule based on the ports. Both of the ports we visited required additional transportation once on land in order to see historic landmarks or find a low-key beach. Some shopping was available port-side, but it included mostly vendors that you see at every port (jewelry, t-shirts, Del Sol, etc.). The most memorable parts of our cruise were the excursions or the on-board activities. If you're looking to go somewhere specific, it may be a better use of time to fly directly to that port and stay at a resort.

8) The cruise was extremely comfortable. The weather was warm (70-80 degrees F) each day and the water was surprisingly comfortable, even though it was winter. I forgot when packing for this warmer weather that the cruise ship is kept to cooler temperatures. Next time I'll bring a cardigan to wear around the cabin and dining room.

9) The food onboard was sublime! Correction - dinner was sublime. All of the other meals and buffets were mass quantities of average quality food. In order to take advantage of the best meal of the day, I recommend having a light breakfast and making healthy choices at lunch. Don't feel like you need to finish a dish if you don't enjoy it.

I went onboard with a variety of food intolerances. While I'm sure that wait staff would have been more than happy to accommodate those, I was delighted to find that taking digestive enzymes before every meal allowed me to eat menu items worry and pain free!

Though I'm writing this mostly for my future benefit (very selfish of me), maybe you will get some use from this information as well. Bon Voyage!

Birthday Cruise

It was the best birthday cruise EVER!

The Freedom of the Seas, our Royal Caribbean cruise ship, went on an Eastern Caribbean route in the middle of November. Ports included Royal Caribbean's private island in the Bahamas, St. Thomas, and St. Martin. It was a seven night tour, with three sailing days and two formal dining nights. I've been on two cruises before this one, but this was Scott's first cruise. It was a first class cruise, and I would definitely book Royal Caribbean again.

Memorable events on our cruise:
Dinner
Dinner in the main dining room was something I looked forward to every day. Food is such a crucial make-it-or-break-it factor on a cruise, so I was pretty nervous coming on board with several food intolerances. I give all credit for the success of my cruise to Digest Gold digestive enzymes. I took one before every meal and that allowed me to eat what everyone else was eating worry and pain free. LaraBars, my fav downtime snack, are a runner up for making my cruise healthy.

We had fantastic servers in the main dining room. Scott thought that Anthony, our main server, was hilarious. On the second night, Anthony came to take Scott's empty entree plate away and asked if he would like to try any of the other entrees. Scott mentioned that he had thought about one other dish specifically, but he was saving room for dessert.

"Oh," Anthony said. "We don't serve dessert on Day 2, so you might as well order it." Scott readily agreed.

After Scott practically licked his second entree plate clean, Anthony brought out the dessert menu.

Anthony would often bring Scott any of the dishes he mentioned an interest in (three desserts, four crab cakes…) , so Scott had to choose his words wisely.

SeaTrek Underwater Excursion
One of the best decisions we made was to do a shore excursion. We wanted to do something unique and the SeaTrek underwater helmet dive fulfilled that. Even though it was a rainy day, the water in St. Martin was pleasantly warm. We snorkeled with the fish and thoroughly enjoyed our tour of the bottom of the ocean.

My most memorable moment of the entire cruise was having a school of fish eat fish food from my hand. It was like a million tiny suction cups sucking up the pieces on my fingers.  You can't tell in the picture, but I was giggling uncontrolably under that helmet.

Poolside TV

I wouldn't necessarily say this was my most memorably event, but Scott will always remember watching weekend football games on the big screen while sitting in the Jacuzzi.

The whole vacation was perfect, which is more than I could hope for in celebrating my 30th birthday. It was the party of all parties… which Scott now thinks we need to plan for each of my birthdays.

Word.

Snow Days in Oregon

We returned from our warm weather travels just in time for a snow and cold front in Oregon. In our three years in the Willamette Valley, we can only remember one other significant snow in March 2011. The weather this weekend has definitely topped that.

This was the first time that roads were closed due to poor conditions and accidents. This was the first time Western University cancelled classes due to weather in the Willamette Valley. This weekend was the first time that church was cancelled due to poor road conditions. This was the first time that the OSU Foundation has closed, while I've worked there, due to poor weather. That may be the most unusual event of the weekend!

Scott and I enjoyed a nice, safe, lazy weekend inside our warm apartment. We ate soup and warm, homemade applesauce. We studied for exams, and we looked a pictures from our cruise. I'm starting to wonder if I scheduled our cruise a week or two too early.

Med School Update: OMM

Student Doctor Chandler's last rotation was only 10 minutes from where I work in a clinic that I have frequented before. The Heartspring Wellness Clinic in Corvallis (part of the Samaritan Health System) is home to one of the only practicing osteopathic manual manipulation specialists in the area. If you live in the Willamette Valley and have muscoluskeltal pain, I've heard that Dr. Myers can work wonders. I heard that from Scott who was so impressed to hear most patients were referred from other patients and saw they left feeling a great relief from pain. Scott worked with this doctor and an Internal Medicine resident from 7:30 Am - 5:30 Pm each day. Scott said the doctor had 10 one hour appointments each day with little time for lunch. Scott, however, was required to attend lunchtime lectures at the Corvallis hospital each day as part of his rotation. 

Scott describes these OMM treatments as being much different from what he learned in school. While the basic concepts were the same, Scott said his preceptor took the manipulation to a whole new level. This doctor could do a light palpation, and without any patient description, find troubled musculoskeletal areas. He would then apply several different treatments at the same time. Some of the treatments Scott was familiar with, and some were new techniques that his preceptor taught him during these four weeks. The doctor was also trained in acupuncture and would needle a patient if appropriate. 

I was lucky enough to play the victim most nights for Scott's manipulation practice. Before you go all dirty with that last sentence, that means that Scott tried his OMM techniques to help with my neck or back pain and even alleviate some concerns with my Crohns (troubled ileum). It was fun to see Scott so excited about these new techniques and the outcome that they seemed to produce. 

In addition to working with patients in the clinic, Scott was invited to watch an after-hours clinic that his preceptor conducts with OSU athletes at Reser Stadium. Athletes from all of the sports at OSU have access to a team physician and orthopedic doctors. However, they find that some cases are best suited for OMM and have a clinic twice a week for these cases. Having the opportunity to see OMM in action in a sports medicine setting is right up Scott's alley.

Scott feels extremely grateful that he had the opportunity to do his OMM rotation with this particular doctor. It raised OMM to a new level of practice and education. He now feels that he would like to practice OMM with patients the majority of the time, but not all the time. He still likes the idea of family practice, sports medicine or PM&R, integrating OMM throughout. 

Next rotation - VACATION! Four weeks of blissful relaxation… oh, yeah, and scheduling all of his rotations for 4th year. Still, he can watch sports while he's researching those options, so I think it's still a vacation.

Med School Update: Elective

If you know my husband, you know that he loves sports. He loves to play sports, most especially, but watching sports is a frequent past-time of his as well. From the very beginning of medical school, before we had even arrived really, Scott would say that he imagined himself going into sports medicine as a specialty. He didn't even know what that would entail. He just liked the idea of working with athletes, and if it meant he could watch a game on the sidelines as team physician, that didn't hurt either!

As Scott began his rotations this year, he began to have a better idea of how he wanted to practice, no matter what specialty he eventually chose to pursue as a career. He's discovered that he prefers to work in outpatient clinic settings, as opposed to large hospitals. He would like to incorporate osteopathic manual manipulation (OMM) into his daily practice, because he likes working with musculoskeletal problems and giving patients some immediate pain relief in a natural way. He continues to think that sports medicine is the way to have a practice with these aspects, but is open to other possibilities including Physical Medicine and Rehabilitation (PM&R).

 

This last rotation was Scott's elective, which he set up with a former Western University graduate who now works in Portland as a sports medicine/family physician. This doctor happens to be the team physician for a hockey team in Portland, and he works in an office where other physicians have team physician responsibilities in the area. This doctor, also happens to have Tuesdays off on his schedule. So Scott didn't have to go into the clinic on Tuesday's. This inspired Scott to tell me that when he grows up, he'd like to take Wednesday's off. "Then I could work two days, and take a break. Work two days, and take a break."

 

It was clear, pretty early on, that this rotation was different for Scott. It may have been the first or second day when we had this exciting text conversation:

Scott: [This doctor] does a lot of OMM.
Me: That's cool! You should ask him if he has an problems reimbursing for OMM.
Scott: Nope
Scott: And he listens to ESPN radio during the day.
Me: Wow! I'm surprised you haven't already declared this your dream job!
Scott: It's never good to declare.
Scott: I'll be going to a hockey game with him too.
Me: You're so special!
Scott: Thanks hon!

The picture above is when Scott attended the hockey game with his preceptor. Scott hasn't "declared" his future career in words, but in my mind it's close enough.

Med School Update: First Didactic Week

Source

I have slacked a few days in posting about Didactic Week. As I briefly mentioned before, the medical students schedules in years 3 and 4 include a one week break between rotation blocks (blocks include three 4-week rotations). During didactic week, all students in that year return to campus.

Since there are approximately 100 students in Scott's class and only one-third of the third yearders are based in Lebanon, that meant that there were a lot of students looking for housing. Two of Scott's med student friends asked if they could stay with us during this last didactic week, and we were more than happy to house them. That may sound sarcastic, but we really loved seeing everyone from the class again, and I know that Scott was giddy having so many friends with which to share medical jokes. I loved hearing all the rotation stories and the student's insight into their future career choice.

To give you an idea for what the students do during the week, I pulled this description from Western University's website...
Didactic weeks take place on campus and will include, but not limited to, the following activities related to the disciplines they have rotated in for the prior 12 weeks:

1. Facilitated case reviews
2. Objective Structured Clinical Examinations (OSCEs) which include: a. Videotaped graded Standardized Patient encounters b. Post-patient written S.O.A.P. notes c. Post-OSCE video review
3. OMM review session
4. Standardized subject examinations
5. Completion of CoursEval surveys related to the rotations block and the didactic week

Before the week began, Scott mentioned that he was pretty nervous about the standardized tests. The test is a standard test administered nationwide, and the subject of each student's test is based on the completed rotations. Scores from these tests are included in your transcript and can be viewed by residency programs. The school hadn't provided any idea for what material would be covered based on their rotation subjects, and since each clinic is different, Scott wasn't sure if he would have all the information he needed. Student took the tests during the first two days of didactic week, and all of the students I talked with reported that the tests were difficult.

The school suggested that students plan to be occupied from 8:00 Am - 5:00 Pm during didactic week unless told otherwise. There were really only a couple of days during this didactic week where that schedule applied. Most days didn't start until 9:00 Am ended before 4:00 Pm. The joke of the week was that with that kind of free-time, Scott would likely visit the golf course no less than three times. You can ask HIM how many times he actually went.

Block two, here we come!

Med School Update: Family Medicine

Third year rotations are organized into blocks of three rotations, separated with a "didactic week" on campus to review rotations and prepare for the next block. Scott just finished his third rotation of the first block, which happened to be with a family medicine physician in Medford (time is flying by!). His block included OB/GYN, Pediatrics, and an elective rotation. Because Scott's elective rotations were so early on in the year and the hospital systems were struggling to keep up with the scheduling of regular core rotations, it was difficult for students to schedule electives within their hospital systems. We were really lucky that Scott was able to arrange for the elective to be with a physician that he had previously shadowed last summer. It really worked out to Scott's advantage, because this experience provided the best insight for Scott into the career path of a family physician. 

Sorry, I failed to take a picture of Scott at his family medicine clinic in Medford. The clinic was part of the Providence hospital system. While on his rotation, Scott conducted patient exams and would help in the walk-in clinic. While family medicine clinic sees a plethora of symptoms, common diagnoses during these four weeks were diabetes, hypertension, and high cholesterol. He heard a heart murmur, which can be an exciting event for a student who has only previously heard recordings.

Many family physicians select the specialty because of the variety of cases that come through their office each day (as opposed to sub-specialties that focus on one body system, or for some surgeons one limb). This desire to avoid monotony was also the motivation for the physicians with whom Scott rotated. In the evenings, Scott would tell me about the array of cases he saw that day and how the physicians' analysis was very intelligent and sometimes over his head. He asked the physicians what they enjoyed about their jobs and work/life balance. They mentioned that the pay is comfortable for their families, though they prefer to live comfortably within their means as opposed to extravagantly. The family medicine physician plans to retire in his mid-50's. From the stories I've heard, the physicians have good work hours and family time, though they often take business phone calls at home and are sometimes on-call with the clinic. 

Overall, Scott really enjoyed his rotation in family medicine. He left feeling that because of the great physician examples he saw, that he would continue to consider a career in family medicine. 

Now all the third year students are returning to Lebanon for their didactic week. This is something that Scott and his classmates have commiserated on, as no one seems to know what didactic week entails. They do know that they will have two patient encounters (with actors) covering a diagnosis from their block of rations. However, the students have debated whether or not those encounters will be conducted and graded based on how they would be conducted in the clinic or a school rubric. Other didactic week activities are also unknown, though likely will be explained on the first day. For those who are interested, I will be sure to post a post-didactic week download. 

The second block of rations will begin next week. Scott's second block includes Sports Medicine (Family medicine base), Osteopathic Manual Manipulation (OMM), and his vacation block. We purposefully scheduled the vacation block in the winter in order to give ample time to celebrate my 30th birthday...

Which leads me to a shout-out to my best friend, Maura! Happy 30th birthday week! I'm so lucky to have a best friend who understands me so well that she knows how I think, even though I am the worst communicator! Whenever I spend time with her, I come away smiling for hours. Just being around her and her family makes me happy! On top of  her amazing friend skills, she is a wonderful mother and wife, and a great example to me in those roles. I hope you have a fantastic birthday, Maura!!

Med School Update: Pediatrics

Scott's second rotation was in Pediatrics. The pediatrics rotation was broken up into two units - inpatient and outpatient. Outpatient was up first for Scott, and lucky for us the office he was rotating through was right across the street from us in Lebanon. While there Scott helped with many well-baby check-ups, circumcisions, and conducted histories and physicals for children that came in sick (rashes, fevers, etc.). While he was listed to shadow one preceptor physician, he ended up working with all the physicians. He would come in with the first physician at 7:30 Am, have a fifteen minute lunch between the last physician working the morning and the first physician with an appointment that afternoon, and then Scott would stay until the last physician left in the evening around 6:30 Pm.

Inpatient pediatrics was much different. This particular inpatient pediatrics rotation for two weeks was located at the regional hospital in Corvallis. Scott primarily worked with one physician and one resident. He needed to be at work around 7:15 Am in order to do pre-rounds and rounds for those children staying in the hospital. The hospital hosted brown-bag lunch education sessions for residents and students every day. After lunch, Scott would study his pediatric "case clips" online until a real case happened to come through to their office. Throughout the entire four-week rotation, the curriculum required Scott to complete "30-something" online case studies covering a variety of pediatric topics to prepare himself for what he might see in the clinic. The cases took over an hour each to finish, but were easily accessible online and could be done at home or when waiting in the hospital.

The biggest value from this last rotation was the time that Scott was able to spend discussing cases and his future with the current intern/resident. This resident provided some valuable insight into what kind of efforts Scott would need to take to pursue a specialized medical career, as well as advice on what specialties to look at based on Scott's interests. Scott left the rotation having a better idea of how he wanted to practice medicine, even if he's not quite sure what field that will be.

The Future Of Medicine

Recently, Scott and I have been discussing the family doctor conundrum. There is an obvious shortage of family doctors in the United States. Many osteopathic medical schools have, as part of their mission, a goal to help breach the primary care physician gap. Yet, medical students are exiting with an average of $166,750 in loans with up to $300,000 in interest costs and a pay back period of 10-30 years. Not exactly incentive to start a career in family medicine, sending some of the best future doctors on the path to higher paying specialties.

From my perspective Scott has been open to considering all of the specialties he encounters as potential careers; but he has received feedback from too many residents and physicians that he should stray from family practice, as it can't possibly provide a living for families.

Dr. Edwin Leap, an emergency room physician and writer, summarizes this conundrum that medical students are feeling in his address to Clemson University, "The future of medicine for aspiring young doctors":

"With young physicians exiting medical school with debt burdens in the range of $160-180,000, and with reimbursements for their care dwindling below the cost of running a practice, we are fast approaching a breaking point. Physicians with that kind of debt cannot buy houses, cannot easily have children or even automobiles. And opening innovative practices, in which they are business owners, is nearly out of the question. Into that mix, the likelihood that they will have either inclination or capacity to see the poor at a reduced rate (or for free), is next to zero.

It also makes the lower paying primary care positions nearly impossible, unless those positions are supplemented through loan repayment or scholarships."

Sounds like a gloom and doom situation to me.

One of the most frequently asked questions Scott receives when he meets someone new is "Do you know what specialty you want to pursue?" It seems funny that society is also driving students, with their small talk, to aim for a specialty. In these first two years of school, I haven't heard one student mention that they are hoping for a career in family medicine (though, Scott reassures me that there are at LEAST two). I, for one, am disheartened that my future pool of family doctors may not include the most creative and ambitious doctors.

Things may turn around in the next decade. According to recent studies, there is hope that the average salary of family physicians will continue to rise. Dr. Edwin also made a suggestion in his speech that would incentivize a career in family medicine and help with health care costs:

"What can we do? Among other things, we could structure loans to allow physicians to get credit towards those loans at a Medicare rate for each non-paying patient they see. Over a few years, they could work off that student loan debt. The same applies to other physicians in practice, but perhaps without student loans. We could allow them to receive tax deductions based on the same formula for caring for the indigent. A simple solution. It would provide care. It would build good feelings and rapport. And many of those cared for would one day have jobs, and insurance, and become paying patients of those physicians who saw them in their time of medical, and financial need.

This has been suggested by many legislators, but never enacted. It appears to reward the rich. Pity. Doctors, and especially primary care providers, are fast losing their financial power, even as they are considered wealthy. For future physicians to thrive, this perception has to be addressed."

The pressure is mounting. I think I can speak for Scott, though, when I say we're giving all of our possibilities, including family medicine, a fair chance. Starting today Scott is on rotation with a fantastic family medicine physician. We will see how our debate changes.

It Was Time

Oh, it was more than time! For several months I tried to convince myself that I needed long hair - more lying to myself, saying that I would replicate cute up-dos. That didn't happen... not once. When the weather in Oregon started turning hot and the hair went straight into a ponytail on a daily basis, I decided it was time for a cut. I am more than satisfied with the results! This cut really isn't a new style for me, just a classic standard.

Each week I'm reminded that I need to blog and share what's going on in our lives, but each week I struggle thinking about what is "new." Monotony is my life right now, and it's comfortable. Scott is doing his rotations nearby. Working by day, soaking up my honey time by night. HIS evenings are spent reading up about pediatrics. Do I dare say that we have also multi-tasked our time geeking out in a hobbit sim-city game? Yeah. I'm an elf. Feel free to call me names.

When I'm not a fantasy nerd, my nose is stuck in a book. I've read eight books this summer and am on my ninth. I miss my casual reading time when school is in session! This summer has been prime for a catch up. Oh, I take reading requests. Only a few weeks remaining before my classes begin again in the fall. Two classes per term this year, in attempt to close this deal.

Nothing much "new" in these-here-parts. If something exciting happens, I'll take a picture and send it your way. Scott's usually good for a post update now and then!

Med School Update: OB/GYN Rotation

Scott barely finished his first rotation of Year 3 - four weeks on the coast of Oregon at an OB/GYN clinic. Before the rotation began, Scott was pretty nervous to enter the clinical setting. While COMP-NW prepares their students for the clinical years by prepping them for board exams and having each student complete one clinical course each year, the students have limited exposure to real (non-actor) scenarios. Luckily the hospital in Newport did great job introducing Scott to the clinical world. The first week, Scott primarily observed typical procedures and cases in the clinic while answering pop quizzes from the physicians.

One week of easing was all Scott was allotted for his first rotation, as it was a busy baby season on the coast. He assisted with three vaginal deliveries, five c-sections, and a hysterectomy. The doctors also allowed Scott to conduct patient exams, collect complaint histories, and assist with vaginal exams.

I'm really proud of the habits Scott formed during his first rotation. Since he was living on the coast and I remained at home, Scott made himself available on-call every night. This allowed him to participate in many of the procedures I listed above. Though I didn't imagine he would be doing any studying while on rotations, Scott took the next day's visit schedule and would study key concepts the night before. He made good friends with the labor and delivery nurses, and they were kind enough to show him the ropes of surgery prep and delivery.

Rotations really give each student a good glimpse into what each medical specialty would be like as a career. While I don't suspect that catching babies has moved to this top of his list, Scott did mention that  OB/GYN has the potential to be an interesting career choice. "There's a good mix of surgery, deliveries, and clinic. You get the nine to five with office visits, no other specialty deliveries babies (exception of some certified family practice docs), and on top of that you could do some pretty interesting surgeries."

As for me, the four weeks apart was not as bad as I had anticipated. Scott and I have had extended time apart each summer (first year for ISAC, second summer for shadowing, and now for rotations). We were able to arrange our schedules to visit each other on two of the weekends. I also kept myself very busy as usual. Though Scott does have five more away rotations (two electives, and three more costal rotations) this school year. So we'll see if I'm whistling the same tune this time next year.

Heaven On Earth - Exit 86

Yes, this is a restaurant review and not instructions on how to find heaven in Oregon. Heaven On Earth is this log cabin restaurant I've seen along I-5 between Medford and Roseburg that I have been anxious to visit - mostly on account of their large sign stating they have world famous cinnamon rolls.

When I drive with Scott we avoid stopping anywhere, even if we see a sign that says world famous, final sale, raspberries, or any other phrase that would normally grab my attention enough to pull off the road for a peek. I've become so used to that routine of non-stop driving that I would have passed by Heaven On Earth again. Except, as fate would I have it, I was searching for the nearest pit stop for an emergency bathroom break on my way home. THE next available exit (Exit 86, or as my waitress suggested, "Just 86 yourself off the highway!") happened to be home of this restaurant and bakery. It's really out in the middle of nowhere!

The restaurant inside was exactly what you might imagine a log cabin that claims to have world famous cinnamon rolls would look like, with servers to match (not like Paul Bunyan, cute baker ladies and men). When I entered I was greated by pies and cookies and rolls of every sort, all homemade in the bakery next door. I was actually greeted with a woman who offered me a sample of their fine cookies, which I couldn't eat due to my diet SLASH increasing need for the women's room.

After exiting the ladie's room, I noticed how many people frequent this exit attraction and looked around at all the tables where I presume meals were served. The servers were INCREDIBLY cheerful and were the best chit-chatters I've met. Maybe it's a rural thing?

In any case, my purpose in stopping was to use the bathroom and purchase a world famous cinnamon roll for Scott. As it so happened, that day the first batch of cinnamon rolls had been rushed and hadn't fully risen to world famous heights. I was assured they were still delicious, but they offered me two cinnamon rolls for the price of one ($5.95). My Scott's lucky day!

Scott's review: the cinnamon rolls were tasty, but a little too much like a loaf of bread. Definitely better warmed!

It's likely their world famous title is derived from similar means as the pies of The Nugget restaurant in the Sitka, Alaska airport. The pies are good, homemade with love. What makes them famous, though, is not their ingenius recipe, it's the fact that they are sold to hungry hungry tourists.

A Little Independence

Over the holiday Scott was on call for all the potential babies coming through his rotation clinic. I took that opportunity to travel south to visit my parents who were hosting my brother and his daughters. I hadn't seen those cuties (sure, Matt's cute too) in a year. They have grown up so much! I loved that they were excited to see me, though sometimes the littlest of them would forget my name. No biggie!

After breakfast, I spent the morning distracting the girls with card making and My Little Ponies. I instructed them to get dressed for the day and see if their mom had helped them to pack something patriotic.

All of a sudden I started feeling awful stomach pains right underneath my ribcage. My mind started racing to what I had eaten the day before. I've been so good on my new diet regiment - avoiding sugar and starches and instead eating mostly fruits, veggies, and protein. I hadn't eaten anything suspect that day or the day before!! Drowsiness overwhelmed me. I tried taking a short nap while the stomach pain lingered, but I woke up with more pain and, on top of that, nausea.

About the time I was anxious for any cause to blame, my mom called from girls camp. She was there as the camp nurse and was then caring six girls with the same symptoms as me. She diagnosed me with a 24 hour virus.

And what an awful virus it was!! I was seriously in so much pain and no medications made a dent in the problem. I was beginning to wonder how girls could even survive suffering through the same virus but in the wilderness (even if they did have the best nurse to wait on them)! That stinkin' virus caused me miss all the fun of the 4th of July - the BBQ, the swimming, the fireworks! Then as suddenly as it came, the pain was gone.

I still don't feel as good as I did traveling down for the visit, but there are no virus after shocks. Just sad I missed precious time with my nieces. When I came out from my slumber and completely sanitized, the girls were giddy that I wasn't sick any more. I had the best welcoming committee back to reality!

Checking Up on The Hubby

This last weekend I drove to Newport, Oregon to visit Scott. He just began his first rotation at the OBGYN clinic at the Samaritan Hospital. His first week included a lot of uteri and observation. So no med school update as of yet, except to say that he is learning beaucoup! Scott asked if I would come visit him and it seemed like the best timing, considering his next rotation on the coast wont be until the winter. Little did I know that I was also beating the 90 degree heat in Lebanon, in exchange for the comfortable 75 and breezy beaches of Newport. A fair exchange!

Scott had asked around at the hospital for local suggestions before I had arrived. He had our whole day planned out. First we would go to lunch at a local hot spot. All the tourists go to Mo's, he was told. Instead he was directed to a restaurant with Ocean in the name... except he forgot the rest of the name and we were on the coast. There were a number of restaurants with ocean as part of the name. When we walked down to the historic Newport boardwalk, we picked the restaurant with Ocean in the title that sounded most familiar to Scott. Lunch was good. Come to find out later, we had chosen the wrong ocean restaurant! So I will have to go back another time to blog about the local favorite.

It was Scott's idea to close the day with a tour, including the hospital he was rotating through and a walk to the beach with the puppies at his host home. I was surprised how much I loved hearing Scott talk about the clinic and all the tools he was using. Usually when he tries to tell me about medicine, it either grosses me out or more likely bores me to day dreaming. It was fun to see him so excited about what he's learning with this hands-on part of medical school. Scott looks at the schedule the day before to see what he needs to study at night in preparation for his visit. I'm sure this will help him make a good impression with his preceptors and patients.

On Sunday, we went to church in Newport. There is only one ward in Newport (other wards and buildings along the coast), and it is part of the Corvallis stake. It was the first time I remember being in sacrament meeting and there was no bread to break and bless. The presiding counselor stood up and announced that the bread they had in the building was rather inedible and we would sing and listen to hymns until new bread arrived. We heard a boy behind us ask his parents, "How is bread inedible?" The ward was really welcoming, even though we were among many visitors. We were told there were a few members working at the hospital, so Scott may have more connections there than he knows.

It was a great trip, well planned by Scott! Because we hadn't seen each other for a week, it felt a little bit like we were dating again. Fun, but I'm anxious to have my hubby home again.

Inactive Crohnie

I had a colonoscopy on Monday and was told that as far as the doctor could tell I had no active disease! Woot Woot! Of course, the doctor said this right before he told me that the scar tissue around my ileocecal valve is so bad that he couldn't even take the scope in my ileum where Crohn's resides. My nurse informed me before my exam that I would get pictures from the procedure, which I could post on Instagram at my discretion. Hmm.. tempted, but I would feel a bit scandalous putting a picture of my bare gut on the Internet. So instead of a picture of my scarred ic valve, you get to see an image of the poster I stared at as I waited for my procedure to start.

Source

No active disease make this girl very happy! The only set back now is that despite having no active Crohns in my visable intestines, I continue to experience weird symptoms (nausea, fatigue, bloating, pain). Without getting into too much detail, I've traced these strange symptoms to my diet, with sugars being the biggest culprit.

This discovery spurred investigation into various diets - Candida diet, The Maker's Diet, paleo, keto, clean, raw, you name it. Basic principles to follow:
1. Refined sugars are not good for your gut and are likely the cause for many modern diseases.
2. Be careful with grains and starchy foods (how you're careful depends on the diet).
3. Drink plenty of water.
4. If you're experiencing crazy symptoms, you may need to eat very very basic/clean for a couple weeks in order to normalize your blood sugar level and gut flora.
5. No one will want to come over to your house for dinner (especially dessert) during that time.
6. Most of the diet is temporary, but some basic principles may, out of necessity, turn into habits.

Good thing my husband is doing his first rotation on the coast! I'm sending my entire home inventory of sugar-laced food for him to snack on while I attempt to jump start this diet process in his absence. At that point I will be challenged with not breaking my diet at work and in my spare time discovering a way to reverse scarring.

How is the USMLE Step 1 Scored?

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I mentioned earlier this month that my second year med school student is studying intensely for his board exams to be taken before he starts rotations at the end of June. Test day has already arrived for fellow students, and we have heard some dejected reports. I know these students - they are incredibly smart, have studied for many long hours, and proven on practice exams that their study plans were helpful. These are students that are getting honors in classes at Western University - COMP NW. I was more than surprised to hear them say that the board exam was so hard they were sure they had failed. Besides making us nervous, it made me think that the scoring of the exam must not be simple (example of complicated: GMAT scoring algorithm).

Its not simple! The USMLE Step 1 is a test sponsored by the National Board of Medical Examiners (NBME). The board exam consists of 322 multiple choice questions taken over an 8 hour time frame. The final score is shown as a three digit number with the maximum score on the Step1 being 300. According to the sources I referenced, it is impossible to get above a 295. A passing score is around 188 (passing score changes periodically), but students typically aim high for 245. The NBME isn't clear on how the exams are scored, but from my research it is clear it is not based solely on the number of questions answered correctly. From what I read, the exams may be scored based on how you compare with other test takers' performance in the three months prior to your exam. Since each test is comprised of different questions, NBME uses "equating" in the final scoring in order to make sure score results are comparable for students across the country.

Are you confused yet? Yeah, me too! The main fact I discovered is that the exam is so difficult it is NOT uncommon for students to leave the exam feeling like they have completely bombed it. I've heard mention of double negatives and purposeful trickery in question wording. One former medical student wrote that of the seven exam sections, the anatomy section was so advanced that many currently practicing surgeons would be surprised with the content.

These facts were only a slight relief, if that, to my med student husband. It was however, immensely relieving for me! Test scores take three to four weeks to be announced, so I would rather spend that whole time temporarily relieved. Regardless, I remain positive that my med student will perform to the best of his abilities, and we will have an adventure no matter his scores. Not to mention a Man of Steel movie celebration when he's done!


Reference:
USMLE Outline of Step 1 Exam
USMLE forum discussion from 2008
National Board of Medical Examiners
USMLE Frequently Asked Questions
More recent forum discussion

Just in Time to Save the World

I'm taking a final exam tonight! This semester in my MBA I took a supply chain management class. The professor's focus was teaching us how to think as a manager of a supply chain. Rather than memorizing various theories and SCM terms, we reviewed international case studies, best practices, and read articles describing what good supply chains look like. I typically associate SCM with manufacturing products - hard labor and the machines that make it easier. The average CEO has now deemed me naïve, as I am beginning to realize that supply chain management is more about efficiency and logistics which can be applied to all businesses and services.

In our class, we had many discussions about a for-profit company's role in social and environmental accountability as well as sustainable resources. Because of public demand and an understanding that future resources means future profits, the business world is paying more attention to this topic. It was interesting to read about how the whole supply chain (even the distant second cousin supplier) will take initiative to improve the quality of the product or ensure a sustainable future, like in this food safety example (link) or this response to a disaster (link).

As discussed in the linked article about the disaster, more companies are moving to just-in-time distribution, meaning they keep little inventory on hand in order to reduce waste and overhead cost of keeping a safety stock. In order to be successful in this, companies must have a vast network of trusted suppliers, and sometimes parallel suppliers providing the same cog in your product to hedge risk. This network is often outsourced overseas, to the disappointment of many.  But Thomas Friedman, author of the book The World is Flat, has found that these international supplier networks improve international standards of living, require trust and commitment from the entire chain, and thus keep the countries of these networked countries out of war. He calls it, in his book, the Dell Theory of Conflict Prevention and says this:

All this makes SCM more intriguing to me and I'm now looking into how SCM relates to the non-profit world, like in this article (link). I would love the help if you have ideas! I'm also curious what best purchasing practices are when it comes to extreme couponers, because I would love to see my product of choice on the shelf more often. Haven't been able to find any articles on that yet.

2013 Strawberry Festival Parade



Lebanon, Oregon has a few things going for it, including the Strawberry Festival which takes place the first full weekend in June. Each year the Strawberry Festival is centered around a theme. I remember our first summer in Lebanon the theme was Strawberries in Paradise, which featured more than one float with a gambling theme (pair of dice...). You are going to smile at this year's festival theme - it was "Strawberries of the Round Table." I'm not sure who was inspired with the knowledge that strawberries were a favorite treat of King Arthur, but the participants in the parade should be rewarded for their creativity with the theme!

In fact, it's hard to choose a favorite. There was the knight riding a bike, trailing his captured dragon friend. I was pleased that the Boys and Girls Club won first place for their float featuring animated strawberries... as knights... battling a realistic animated dragon. Seriously impressive! There was also some parade features with no aparent relation to the round table, such as an electric guitar weilding viking, square dancers, and pirates.

I only stayed for the first half of the parade (it is a LONG LONG parade, and was a hot day!), but I was thoroughly entertained. Another successful celebration of strawberries, Lebanon!

Med School Update: Step 1 Prep

If you've found yourself thinking recently, "I wonder what Scott is doing..." keep this picture in your mind.

This needs to be documented. I really didn't think it was possible, but Scott is indeed studying more for his board exams that he ever did for each of his courses. Scott likes to say this emphatically, mentioning that he also thinks he's learning more through board study than he ever did in his classes. I'm not sure that is the best addition to that sentence.

Board exams are crucial (though I generally like to downplay this fact when I'm talking to Scott so as not to amplify the pressure)! Osteopathic medical students typically take two different board exams between their second and third years, the USMLE Step 1 and COMLEX Level 1. Students must pass the board exam in order to move on to clinical rotations with hospitals and clinics. Even more than that, these first board exams will determine your residency options (insert pressure here). This first board exam score is one of the largest factors that residencies consider, even more so than grades from the first two years or your second boards taken after the third year.

So this relaxed image of Scott with his computer, study guides, and snack of choice really isn't unusual for the month of May. In fact, he posted this picture to his Facebook and he received comments from student friends like, "That's me, except with a bag of milano cookies." Here are some board exam resources we are aware of:

• Doctors In Training (DIT)- a scheduled study course that Scott purchased in order to improve exam scores. Scott bases his whole day off what DIT recommends he review that day.
• USMLE World Step 1 QBank- a question bank that was provided by Western University COMP-NW to Scott and all of it's students
• Acland's Anatomy- a series of videos that review human anatomy and function
• Pathoma- an online video subscription discussing pathology
• Kaplan Step 1 course- Western University COMP-NW purchased the microbiology and pharm sections of this course for their students
• Picmonic- Scott purchased temporary access to this tool of lovely mnemonics that help med students remember diseases by way of their photographic memories
• Study with Substance P- audio files created by a now resident describing what is important to know for Step 1

That said, here is a day in the life of Scott from May until the end of June when rotations begin (excluding Sundays):

7:30 Am     Wake up and take USMLE World quiz, 25 questions
8:30 Am     Eat breakfast while watching hours of DIT videos
12:30 Pm   Eat lunch and take another USMLE World quiz over DIT subject matter
2:15 Pm     Go to the gym during PTI (SportsCenter, of course), with study resource for multi-tasking
3:00 Pm     Observe and Serve (Scott insisted I include his daily act of service for me. Today=dishes)
3:30 Pm     Hours and hours of videos, trying to break up the monotony, but continuing on one system
6:00 Pm     Katie time eating dinner, playing Ticket to Ride on the iPad, and reading scriptures
8:00 Pm     Picmonic study
10:00 Pm   Kaplan videos to review microbiology and make flashcards, until he's too tired to see


Method to determine the effectiveness of Scott's schedule - test scores. COMP NW hosted a practice exam on Tuesday this week and Scott more than passed. A nice feeling, for sure! We will be sure to update when exams and subsequent celebrations are over.

Five Years

I remember waiting inside of the Sacramento Temple five years ago this morning, as a newly married couple, waiting to make a grand entrance to our world of excited family and friends, and one of the ladies volunteering in the temple that day brought me my bouquet. I love that bouquet so much! It smelled glorious and was bright and exotic. As I was enjoying the aroma, another volunteer inside the temple came and took my bouquet away, saying I couldn't have it until I went outside. Oops! Well, I guess I could wait. The flowers were placed gently in a vase near the door.

Next thing I knew, the first volunteer was walking quickly in my direction bringing my ball of pink with her - didn't care what anyone said, she thought I needed to have it! Anything to make a bride happy!

High five to my honey! Somehow it doesn't seem like it has been five years. I feel like I'm barely out of college, nowhere near looking my age, and yet I can't seem to remember what life was like without my husband by my side. Anyone else feel like they should still be planning their wedding reception?

Soy Vay House Party

The med students are studying intently for boards and planning their get away from Lebanon, so of course a party was in order and lucky for us Soy Vay was willing to sponsor it! We  had applied for the Soy Vay House Party for this very purpose!

Scott and I prepared chicken kabobs and drumsticks marinated in Soy Vay's Veri Veri Teriyaki. HouseParty and Soy Vay had sent us one large and one small bottle of it, which is lucky because the only other flavor I found in Lebanon was Wasabe Teriyaki and I didn't think that would go over well with the children.

And there were LOTS of kids. We had 34 of our close medical school friends come over for the BBQ. I was hoping all week long that it would be sunny so we could have the BBQ outside next to the playground. Oregon has had some really lovely weather, which means of course that everyone is talking about how we need the rain and someone in Oregon is likely leading a rain dance. They were successful dancers, because it POURED right in the middle of our BBQ as I was trying to push the children outside of the clubhouse to play.

Soy Vay also sent us a shirt for my BBQer to wear! Here he is talking about board questions with his fellow student doctors. There will come a day, very soon, when I will cringe when hearing another medical school test question.

Do you love how we had the Food Network on during our party? I think it made everyone hungrier.

Soy Vay also sent us all goodie bags to take home with recipe booklets and coupons. OH! And a mini Glad container for all, which is very fitting because my friends here always joke that I somehow fit a whole lunch for Scott into mini tupperware containers. Would you believe that sometimes he eats the same amount as me? It's strange.

I love my med school friends so much and will sure miss them when they are off in rotations! I might have to hang that group picture up in my living room, Photoshop in Morgan, Chase, and Colt, and bring it with me everywhere I go!

To the Pro Bowl

Scene: Western University COMP NW campus

Just looking at the picture you would think Scott was teaching a study group, right?

You would be wrong. This is a meeting of "The Second Years" flag football team of the Lebanon Flag Football League. (Yes, that was their official team name. They clearly did not consult a woman before they chose it). The above meeting occured before the semi-final game, where members of the second year class battled against members of the first year class for a chance to compete in the league championship. My husband takes his sports seriously.

So seriously that when he twisted his ankle on the day of the championship game, you would have thought he had broken it. He immediately called his players to prepare a backup game plan. It was also one of the three times in our marriage that I've seen him take pain medication. When he walked on that ankle it was painful, so he prepared to not be quarterback or even play in the game at all.

How long do you think that lasted? I love this picture of him standing on the sidelines that night. You can tell from his posture that he is so frustrated not being in the game.

The Second Years were battling under the lights against a team of local athletes. Since The Second Years were two seed in the tournament, playing against the first seed team, they were listed as Guest on the scoreboard and our cheering section was on the uncovered bleachers. Though Scott and his team were welcomed competitors, you could feel that this championship was more than just a game. The local teams did not want to be beaten in the Lebanon flag football tournament on the Lebanon High School football field by this group of nomadic students. The home cheering section included not only the wives and friends of the home team, but also team members from some of the other local teams.


And it was a great game! Home would make a touchdown, followed closely by a guest touchdown. There was a lot of movement and tension. It wasn't even the end of the first half that Scott was playing again, saying he could barely feel any pain in his ankle (it really did heal up by the next day).

Second half, the game was tied, 42 to 42, with about a minute left on the clock. The Second Years had taken the ball all the way down the field. With their last chance on the drive, they attempted a field goal kick and made it! This certainly motivated the home team, who turned around and made a touchdown with only five seconds left on the clock.

With a team full of (extremely) competitive medical students, this loss was tough. Heads were down. I believe I even heard some loud barking. But I was really impressed with Scott (may have been a side effect of the drugs). He took a leadership role and congratulated all his team members pointing out their best plays. And while the winning team took pyramid pictures in front of their scoreboard, Scott rallied the team for their one and only team picture of the season.

The story doesn't end there, because of course the Lebanon Flag Football League is having a pro bowl game. Team coaches were asked to nominate four players from their team to play. Of course, as coach, Scott nominated himself... as quarterback. This time he vows he wont be playing ankle twisting basketball on game day.

Yr 2 Perspective of a Med School Wife: Morgan

I'm so glad that Morgan started feeling the pressure to participate in my review posts, because I love her perspective. I'm probably biased, though, because Morgan and I have spent a lot of time together since medical school began. Scott and Morgan's husband, Chase, were roomies during the summer ISAC program in Pomona. So Morgan and I were destined to be besties, especially after I was able to score her a job with me at the Foundation in Corvallis. Carpooling, lunch hours, and games nights with the hubbies have been so great. I'm not evening thinking about how they will move for rotations, because I like to pretend that I will still see Morgan and her adorable baby every week.

What are your responsibilities while your husband is at school this year?

Unlike the others that have posted so far, my responsibilities have changed from the first year… but not because its year 2 but because we had our first baby.

So I spend my time taking care of Colt and I do most of the shopping and cooking. I would like to say that I am a wonderful housekeeper, but Chase would tell you otherwise. Thankfully I have a husband who likes to wind down after tests by giving the house a good scrubbing.

Chase likes to always go, go, go. So I try to make sure that he has fun and doesn’t get too worn out.

What did you do differently in year two to support your med student?

I made sure to stay out of the way during test weekends. Chase loves to hang out with Colt and me, and I noticed one test weekend that I was totally being a distraction. I don’t have the discipline to leave him alone, especially on weekends. So I try and get out more on those weekends and keep myself busy.

The first year of med school I was working full time and also coached cheer a couple nights a week. I cut back from coaching cheer at night. It felt like I was away from the house too much,  and Chase has enjoyed having me home every night even if we were just in the same room while he was studying. I am sure having dinner ready for him doesn’t hurt either.

I try and focus on the end goal more. It helps me to remember what is important and why we have to make sacrifices now. For example, right now when I want to take time away from Chase’s board studies, I remind myself that his board scores will help decide what residency program and what specialties Chase can or cannot get into. If I take away too much from his studies now that could affect his path as a doctor and also our future.

How did you prepare for rotations?

I made sure to talk with Chase and see what his expectations and hopes were for rotations. I tried to stay informed and learn about the process as much as possible. It was kind of difficult to get all of the information when I was looking for it, but it all came eventually. I just needed to be patient.

What did your family consider when participating in the lottery?

Chase went and talked with the rotations director and a few of the teachers at school. He also contacted some residents at different DO schools around the nation and asked what is important for the field of medicine that he is thinking and hoping to go into.

After talking with all of these sources, he decided that he wanted to be in a location that wasn’t too small, but not too big either. Some of the places in the big cities have residents also at the hospitals, so it may be harder to get as much hands on experience. But in larger cities you may have the opportunity to see more rare and interesting cases. Then in smaller hospitals you get more hands on experience, but may miss out on having a variety of cases. Chase wanted his rotation site experience to be the happy medium.

Once we figured this out we looked at our different options and narrowed it down to our top five places. Then we further discussed the advantages and disadvantages of each. Our top two rotations sites ended up being McMinnville and Bend. The school put out a Google doc where people put in their top chooses. When we saw how many people put Bend as their top choice, we decided that we would rather put down McMinnville then end up somewhere further down our priority list.

What was the most difficult part of year two for you?

I think the unknown was the hardest part for me also. I feel like the school (and once in a while my husband) could do a better part at informing us of the process.

Another hard part at the end of this year has been finding a place to live in our rotaion site. There isn’t quite as many options in the price range that we are wanting, and since it’s not super close we can’t just make a quick trip to see the places.

I think the next thing that is going to be difficult is moving. Not only because moving just sucks, but because we will really miss our friends and support system that we have in Lebanon. However, it is exciting to move on to the next part of the journey, and Chase is super excited to be out of the classroom and start feeling more like a real doctor.

Any advice for first years?

Stay positive. I think it is easier for you, your medical student, family, and others around you if you stay positive. Yes, medical school is stressful. Yes, we are all poor. And yes, we don’t see our husbands as much as we might like. But this time is precious… and lots of time Chase and I have found ourselves wishing our lives away thinking if only we were in rotations, residency, or if Chase was already a doctor. Enjoy this time because soon you may be leaving your friends and moving on to the next adventure. Plus you want to have a positive effect on those around you!

I will also echo everyone else’s advice… communicate!

Oh and plan lots of parties and get togethers! And take a lot of pictures. It is such a fun time!

Yr 2 Perspective of a Med School Wife: Shaila

Thank you to Shaila, who was willing to share her experiences again this year. You can read her first year review by clicking on this link.

What are your responsibilities while your husband is at school this year?

A day in my life makes me tired and may make you tired just reading about it! We added our 4th boy to our family during the summer and a puppy at the beginning of the year, so that even added to the workload. (Our 4 boys, Malcolm is 9, Quinn is 7, Winston is now 5 and Sterling is now 10.5 months and our puppy, Brody, is almost 6 months.) My "days" would start out by waking up the big kids and getting them fed, dressed, everything put together, so that they could get off to school, where Matt would drive them if he was on his was to school, or I would. Then I get to feed a cute and precious baby and entertain the 4, now 5, year old. Then the rat race begins, laundry, bathroom scrubbing, dusting, vacuuming, dishes, tripping on hundreds of toys, picking up hundreds of toys, organizing, bill paying, errand running, meal cooking, dog trainer, pooper scooper, vet appts, dr appts, kissing boo-boos, comforting, breaking up wrestling matches. Those are just a few of the things I do. What doesn't a mother of 4 boys do!?!

What did you do differently in year two to support your med student?

I didn't do anything really different this year to support Matt. I felt like we did pretty good the first year. I just tried not to vent to him my frustrations of the kids and housework too much (which was difficult as I've struggled with some post partum depression). That might not be the best thing to do, and he doesn't like it that I do that. I try and handle things, as best as I can, before putting any more stress or burden on his full plate. His first priority is his family, but getting this education is what's going to provide for his family in the long run. I tried to keep our bedroom (where he does the majority of his studying) quiet and somewhat clean (definitely not always clean) so that he could focus and want to be home as much as possible. The moments we had together, we tried to make them the most meaningful and stress free, so that he could enjoy the limited quality time he had with us.

How did you prepare for rotations?

I'm not good at seeking out information. So everything I knew about rotations, came from Matt, which let's be honest, really wasn't a whole lot. I told Matt what my priorities were, and pretty much left it up to him. We discussed locations a few times, and I'd let him know what I thought. I didn't play a huge part in the process. Matt's happiness is number 1! If Matt's happy, it makes me happy, which trickles down to happier kids, a happier life. So I wanted Matt to do what would help him achieve the success he wants most.

If it was possible, I didn't want to move. We have kids in school, we've moved around a lot already, and will have to move more in years to come. One less move and more stability would be nice. We live in a beautiful home, with wonderful neighbors, in a culdesac, with a great yard - all things that my kids need, and I love. So in the end, Matt was able to get a rotation in Corvallis. He will commute, and we can stay put. Our kids can feel like life is as normal as possible. Honestly, if we didn't have older kids, Matt would have tried for a different rotation, but Matt's priority is his family. I'm pretty blessed that he feels that way.

What was the most difficult part of year two for you?

The most difficult thing in year two would probably be the amount of stress that Matt had. It was definitely a harder year for him, for many reasons I'm sure. He had to put more time into studying. I know I added to the stress, as I struggled with some post partum depression. He sometimes felt the need to love and comfort me, when he needed to be studying instead. But thankfully we both survived and got through it and love each other more for the love and support we've given each other. Another hard thing, was again, money. I felt like this year was harder financially than the first. Part of that is this second semester, where they had to pay test fees for boards.

Any advice for first years?

My advice for first years, pawn everything you own and keep the cash hidden away in your freezer for future bills. :) Budgeting and frugality is what will get you through this year. Ask your hubby what fees he'll have so you can consider that too.

Make the most of your time together, all the little moments, especially if you have kids, they need those little moments with their daddy (or mommy). I don't expect to have Matt be of any help around the house. I want him to come home and take those moment with his kids, not cleaning or helping with household duties (not that I don't want that!). So keep your expectations low with what you're hubby can help with and what time he'll have to give. If you absolutely need something extra, asking lovingly is what I've found gets me what I want. Haha!

Just encourage him, let him know how great he is, how handsome he is , how proud of him you are, how you believe in him. Little things like that help anyone feel worth more. Good luck!

It's great to know we're ending class study and halfway through this phase. Yay!

Yr 2 Perspective of a Med School Wife: Megan

Megan is a new contributor to my little review game, so I'll tell you a little bit about her before writing her responses. Megan is married to Devin who is a second year medical student at Western University - COMP NW. They have a little boy, SJ, who just turned two. I remember meeting Megan and Devin at the beginning of first year and SJ couldn't walk yet. It was fun to watch him escalate from crawling to running! Scott and I see these three often to play games, talk sports (while Megan, SJ, and I observe), or on occasion find ourselves at Buffalo Wild Wings. We will miss them when they move to Medford for locations, but already hooked them up to live in my parents neighborhood!

What are your responsibilities while your husband is at school this year?

This year I started working at WOW! Fitness' day care. It has been a blessing and a challenge. Our day usually consists of working at the day care in the morning, coming home and preparing lunch for Devin and SJ, putting SJ down for a nap and then heading back to the gym for a couple more hours. I take care of the cooking, cleaning and taking care of SJ so that Devin has time to focus on school. On days that I don't work at the gym I have been busy with my church calling, leading teenage girls.

What did you do differently in year two to support your med student?

The second year seemed so much easier than the first year! All of the initial adjustments that we went through from the first year seemed to have smoothed themselves out. We both knew what to expect. I don't know if I necessarily did anything different, but I have tried to support Devin as much as possible and make his life easier, which in turn makes our life easier! Devin has also done a really good job at making sure that we know, as his family, we are still his #1 priority - whether that means coming home from lunch every day, making sure that we have dinner together, or helping with SJ as much as possible.

How did you prepare for rotations?

I feel like, no matter how much you prepare for rotations and the lottery, you can always end up in a place that you least expect. At least, that's what happened to us! We thought we had everything planned out and when we finally got our rotation locations we were shocked! But it has actually turned out to be a very good thing, and we're very excited about our new location! (Though we are going to miss our friends here tremendously!) So my advice when it comes to rotations, keep an open mind! It will work out!

What was the most difficult part of year two for you?

All of the stress with the boards coming up has been pretty hard! I can't wait until those are over! Test weekends are hard but, if you know they are coming, you can make sure that you have stuff going on that weekend to make it go by faster!

Any advice for first years?

It's always hard not having your husband/significant other around. It's hard feeling like a 'single mom' or just plain single, but you need to remember you're not alone! These days will come to an end, eventually. While it's a big sacrifice for these next couple of years, in the grand scheme of things I would do it again so that my husband can do something that he loves.