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Friday, June 17, 2016

Where I'm going and where my hands have been

I did not forget I have a blog! Well... I did... but then I remembered and here we are. You know I can't lie to you, internet.

Things are happening! I'm in my last semester on the island and that means I'm 50% closer to being a doctor and having a fancy car. Just kidding, I have a crippling amount of debt. Hooray for capitalism! Aside from the debt and 50% a doctor thing I will be entering into a whole new stage of my medical education - clinical rotations. DUN DUN DUN. From what I have pieced together I will be doing anything from getting coffee and filling out charts to real live brain transplants. I'm very excited to see it play out.

However, before any of that happens, I take the United States Medical Licensing Exam Step 1 aka USMLE Step 1 aka D-day aka a really expensive test that tells future residency programs if I'm smart or not and how much more or less intelligent I am when compared to my peers who are also taking this excessively expensive exam. No, but really. It's a very important exam and a huge determining factor for which specialties you will be competitive for come the match post graduation. My school has built in a little safety net where they make you take a mock step 1 or "comp" as we all call it and that is in one month and three days (if you were wondering). It's a good gauge for how well you are preparing for step 1 and is not daunting at all.

When all that is said and done I will be off to: the Uk, New York, Michigan, California, Florida, Connecticut, or hopefully another accredited institution to put all this fancy brain juice I've accumulated over the past 2 years to the test. I'll get to learn how to put IV's in, talk to patients who aren't getting paid to talk to me, continue practicing rectal exams (put a pin in it, I'm coming back), and learn all those wonderful doctor skills your nurse does. After that - who knows where life will take me! And that's that! I'm excited to see what clinical's hold for me and even more excited to tweet the insanity (shameless plug - go follow, I promise I'm sometimes funny)

Whew. Now that I've caught you all up on the finishing basic sciences and moving onto clinical's process I get to fill you in on the wonder that is your last semester of basic sciences. A little known fact about medical school is that you learn how to perform genital and rectal exams on real live people who spend their lives traveling from school to school teaching medical students exactly how to feel a man's prostate. (If you're wondering, approach the doorbell, ask him to bear down, ring the door bell, the prostate will be dead ahead under your finger... wear a glove boys and girls).

We were separated into groups of 6 for the male and 3 for the female and I was the lucky son of a gun who got to go first for the male. Fortunately, he was not as horrified as me and guided me through with ease. I have been told that my technique is fine but I need to work on controlling my facial expressions; APPARENTLY patients don't like it when you look horrified when examining their bits and pieces. The male exam is fairly simple and minimally traumatizing but the prostate is where I feel I really got to shine. First of all, we each got a lube buddy whose only purpose in life is to apply lubricant to our fingers which we were then instructed to apply to the anus with "tenacity like you've done this a thousand times!" So of course I very cautiously applied the lubricant and received a "LIKE YOU MEAN IT" shout from the patient, and thus I finished with a bit more gusto and a lot more horror. He then very calmly instructed me what to do and I told myself "Alright, Katie. You wanted to be a doctor... too late to go to law school now, just do it" and performed my first ever prostate exam. It was... an experience. I know none of you want a description so here's a description - you feel the prostate for symmetry, size, consistency then do a sweep from 12-6 o'clock and 12-6 o'clock the other way. It's very clinical and if you tell yourself it's fine it feels fine. I said "this is fine" a lot. When you're done you quickly roll away (AFTER removing your finger), discard your gloves, tell your patient you'll be back to discuss, and let them clean up/asses new emotional wounds. If done correctly there should be none. All in all it was one of the more interesting experiences in my life but not one I had nightmares over. I did, however, walk around with my finger still in pointing position because I did not want it to touch my other fingers despite it being gloved and washed. So the next time you get a prostate exam think of me and remember your doctor wants to do this just about as much as you want it done.

Onto the female! The female is complicated, choreographed, and multi-faceted. Why we gotta be so complicated? It really was not very noteworthy after the male and I think I had become mostly desensitized but I was still awkward as all hell and still told to work on my poker face. I think the female was much cooler because it incorporated more of what we've learned over the past few years and you get to feel internal organs (cool!).

So. That's what learning to perform a genital-rectal exam is like. I hope I properly informed all of you and you all sign up for a new career as standardized genital patients.

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