Tales From the Other Side

Seems like I tend to zone out for a few months when I transition.  As always I have a perfectly good reason.  I got busy and guess what it's September, yet AGAIN!!  Now I don't need to remind you what this means, do I?  I am sure my PRITE post from last September can help.  Yes it's here again.  I am clearly in panic as this year so far I haven't had any chance to study at all.  Serves me right.  I mean what was I thinking procrastinating until July and hoping that being a PGY-4 will somehow make me invincible and give me unlimited amount of time to study right from July.  Being a PGY-4 is challenging and so far mostly a constant whirlwind.  Running from one place to another and not having an office anymore basically is the life right now.  It's busy and at times quite draining when it leaves no time to actually sit down and study or read.  I do have a light at the end of this tunnel in about two months when I can start my elective months and have more flexibility in my schedule but until then it's the hamster wheel, only much more bigger and my feet get stuck almost every day.

This is my last transition while in residency and change is always hard.  Being in my own office for a whole year was something I got used to and used to look forward to.  It was a feeling of being at a home base which is gone now and in so many ways may be is appropriate because I need to move on in about 9 more months so I can't get too comfortable.  May be that is the natural course of things.  I will probably feel much better as I get to the month of starting my electives and take a breather.

I have looked over my posts from last few years ever since I started writing here and see that every transition brings feelings of being overwhelmed, annoyed and at times pure frustration but it also helped me see that eventually I start feeling like I have grip on things finally.  I am hoping it will happen soon.  In the mean while I have to study for my in service exam so I can move on to bigger and better things like studying for the boards, which sounds oh so pleasant, NOT!!

I would like to come up here and write some about a few great books I have read over the last 2 months of absence but I need to be in a zen mind set to review these books.  I think my zen will come after my in service which is in time with the end of my child rotation which starts in 2 days.
I will peek back in next month to see if I can produce something worth reading but for those of you who read this blog (and it amazes me that so many people read this from all over the world) I will say this much; first rule of being a psychiatrist, be in touch with your inner self and take care of yourself before anything else, (at least for me).  So my absence here is not out of a memory lapse but only out of the survival mode I am right now.

Until the storm calms down a little, hang in there with me because the other side is kicking my behind so to speak and it is going to take a while to start thinking more clearly.  

It's That Time of The Year Again!

Seriously? Why?  Why is it almost October already again?  If you are a Psychiatry resident or any kind of medical resident for that matter in a U.S. residency training program, you don't equate fall with changing colors and crisp in the air; after a long hot smoldering summer.  Fall is literally fall.  Fall from the snoozing horse of daily routine and realizing it is time to hit the MCQs and flashcards.  Even if just for 3 weeks prior to your in-service but now the panic is setting in since "it's practically here."  I almost feel like the Grinch.  Where is my sleigh and dog with the reindeer horns?

Just saying, I have an excuse for being gone for so long.  I am studying or at least am trying to.  I feel like I am stretched too thin with having to read more and more ever since I started outpatient.  I love being in out patient.  To me it is the Utopia that isn't anymore.  I love seeing patients everyday and seeing patients actually get better and show up for appointments.  The never ending cycle of rinse and repeat that is called the inpatient is like a distant memory.  I don't feel stressed out like I used to but I feel more pressured to read more and stay updated more.  Of course this is not to say that while inpatient you shouldn't read but you have more time or luxury to watch your patient and make adjustments to titrate treatment.  Not so much in outpatient.  You have to make decisions based on a limited amount of time you have with them and then see them in a few days, sometimes weeks; depending on your calendar.  So the need to know more and know it then and there is more pressing than when I was a second year.  Now I am having to add prepping for the PRITE and with kids being back in school, shorter days and the need to have some down time in the evening; I feel like I don't have enough hours in the day.  I am never with just myself anymore.

Outpatient is also emotionally more demanding esp. if you decide to take more therapy patients; which I have done.  As much as I love therapy it does takes it toll on me.  Some days I am really beaten down because of what I hear and process all day.  On top of that, as a newly minted 3rd year who is doing therapy; there are many many days I am just not sure what I did or said was even the right thing to say.  I doubt myself and at times I am proud of myself for containing my patient's emotions but it is hard work.  I have to depersonalize at times so I can empathize but stay objective as well.  Thank God for my supervisor.  The importance of a therapy supervisor is actually more clear now even though I had one since I was a second year and had some therapy patient.

But for the time being this PRITE is sucking the joy out of my life as a 3rd year.  It falls in the candy month which is no help because how I will do on PRITE might be a mystery but what it would do to my waistline is no rocket science.  So it is that time of the year again and until the 2nd week of October I probably won't pop in again.  Of course the aftermath will be a post in itself.

So here is to a few more weeks of prep until I check back again.
Stay tuned!!!

PRITE Scores Are In

I was dreading this day for days.  I mean let's be honest; who am I kidding here?  Just because I am in second year of my residency, doesn't mean that I have miraculously stopped sucking at standardized testing.

C.S Lewis says "If we find ourselves with a desire that nothing in this world can satisfy, the most probable explanation is that we were made for another world.”  

Guess what my desire is?  Yup you got it. I want standardized testing to choke on it's own saliva and die.  I think it's time for me to find the wardrobe and may be I will find Narnia.  

Rewind to last year December when I broke all records of doing terrible on a test.  I had to search high and low to console myself that I have done worst but I couldn't.  Even my Mount Everest of USMLE looked like a sand dune in front of my epic and colossal bad performance on PRITE as a PGY-1.  Okay well I had a few silver linings as in my Neurology/Child and Psychosomatic scores but I am sure you get the picture.  Anyway I had big plans to change things in 2013 but I am not sure when I fell off of that train.  I do remember getting on it but it must have been a very bumpy start because I don't remember anything else. 

I blocked the shame and went on with my first year.  July brought euphoria as I became the "Upper Level Resident" and the weekend call grind came to a screeching halt and along came Polly the post call day.  I remember August brought back the panic partially because I realized that I was still dozing off at the train station and also because I had more luggage this time around with increased responsibility of being a chief. Those bags are pretty heavy let me tell you.  I am a sucker for punishment as my therapy supervisor says because why else would I agree to be a chief in 2nd year?  Who does that?  

Generally when residents prepare for in service exams they tend to concentrate on past exams and questions.  Seems pretty simple and does wonders for most people but I'd be damned if my brain worked that way.  I wish it did but it just doesn't.  So I found my Kaplan and Saddock in a box sitting in the garage of my new home that I had just moved into.  Yes I moved - twice - in 4 months.  I told you I am a sucker for punishment.  I dusted it off and promised the study gods that this time it's real.  
And what do you know the gods must really have believed me because right before I was supposed to start another month of inpatient in September; my awesome program coordinator asked me about switching it to a study elective because some one had to switch their elective for a different rotation.  You can't ask for a better alignment of stars now can you?  Alas I need more than just stars aligned and double rainbows and unicorns eating jellybeans. Really, where is that darn wardrobe?  

Long story short, the dreaded 2 days of testing left me completely dazed esp. the second day. Who writes this exam?  I cannot believe that I actually missed USMLE after taking this torture spanned over 2 days. I actually missed the insane logic of those questions, though at that time they seemed worthy of being tossed into the Bermuda Triangle never to be found again.  It took me days to overcome the assault on my senses after those two days in October.  

And then I got the envelop.  It was staring at me in my inbox.  I opened it and instantly remembered why I hate standardized testing.  Too bad it can't choke and die nor can I ship it to Bermuda.  There is no Narnia for me either.  But I found my silver lining this time as well.  I don't have to spell it for you.  You have probably figured out that I didn't do particularly well this year as well but my misery has some solace in knowing the even though I sucked but I did it more knowledgeably this year.  The euphoria I felt as an upper level has gradually transformed into a mature awareness that I know more this year than I did last year and that I have started my ascent to the top of Mount Impossible.  

This year I will stay on the train and make sure it gets me where I need to go next October.  And really I don't want to end up eating a whole packet of Dove chocolates again after the onslaught that is called the PRITE.  Because if there is anything that I hate more than standardized testing, is having to buy elastic waistband pants for work because my real wardrobe may not lead me to an unknown world but it sure does keep me happy in my own.