Time to get back to the books

My parents in Kraków

My parents leave this morning, heading back to the states to resume their own adventures. The 2 months they've been here have been amazing. It has easily been the best summer in years. Even though they were here long enough, and in close enough proximity, to be annoying at times, I wouldn't trade this summer for anything. It'd been two years since I'd seen them and (in my opinion) two months wasn't enough.

But now, as they are about to board the plane, I have to shift my frame of mind and return to my studies. Pathology has its first exam a week from today, biochemistry after that, pathophysiology somewhere in between and then we're in full force in 2nd year. This year is going to be potentially the biggest challenge of my life and I have to get started. Vacation ends today.

Welcome Back!

I had wanted to write a post about how great my vacation was and how relaxed I feel after spending three weeks traveling around Europe, but this is not that post. All of that seems to have disappeared in a matter of hours. Not only did I have an 8am class on the first day back from vacation, but I got to spend over two hours running around the school trying to get some information about upcoming classes (as in tomorrow!) and exams with no success AND I get an email announcing that the school has lost its US Direct Loan funding:

A LETTER TO STUDENTS PARTICIPATING

IN DIRECT LOAN PROGRAM AT PUMS

Poznań, July 29, 2011

Dear students,

This letter is to inform you that on July 20, 2011 the University received a letter from the US Department of Education which states that Poznan University of Medical Education lost its eligibility to participate in the Direct Loan Programs.

The reason for loss of Title IV, HEA Program eligibility is the fact that PUMS did not meet the 75% pass rate threshold for USMLE exams (Step 1 and Step 2) taken by PUMS students. The current pass rate for PUMS indicated by DOE is 74.5%.

The loss of eligibility is effective September 30, 2010, however, the University was informed about the decision no earlier than on July 20, 2011.

According to the decision, the incoming students will not be able to participate in Direct Loan Programs. As for the current students, PUMS may award and distribute Direct Loans and process loans deferments for one more academic year 2011/2012 which will enable the University to take appropriate measures.

Currently, the University is taking its right to appeal against the decision of US Department of Education. Our appeal will be considered by DOE after August 8, 2011.

We would like to assure you that the University is taking all possible steps and measures to continue its eligibility to participate in the student financial assistance programs offered by DOE. Together with our admission offices, we are also looking for alternative loan options for you.  

We will keep you updated in this matter and inform you about our progress in reinstating participation in Direct Loan Programs.

Prof. Grzegorz Oszkinis, MD, PhD

Director

Center for Medical Education in English

You know, medical school is supposed to be hard enough on its own without having to worry about whether or not I'll be able to eat or pay for school. At least we're set for this year, but that still doesn't leave any of us in a great place for next year. I can only hope and pray that the appeal goes through and that this year's USMLE scores are higher. I don't know if I can handle moving and starting this shit over again.

Summer: Now or Never!

My summer this year is short, only  weeks, but I'm  making the most of it. My parents are here in Poland for the duration and we're partying like it's 1984! We've seen much of Poznań already. Last week we were up in Trójmiasto for the Open'er festival and a leisurely week in Sopot/Gdańsk--my old stomping ground. We also held Parent Summit 2011--the first meeting of the parents--and all of it went great.

We're back in Poznań for a few more days now, taking care of business (mostly school and laundry). P's mom is coming down for the weekend to see our Poznań place. Then on Monday, the 'rents and I are starting our epic trip with 4 days in Kraków. P will meet us in Zakopane and then we'll drive together to Budapest. Four days later we descend to Zagreb, Croatia, and begin the beachy part of the trip. We'll have about a week to explore and explore we will. We only have reservations until Budapest so far and we're going to wing it the rest of the way!

The real challenge is going to be trying to study while on this amazing journey. The reality is that we will get back Sunday night and I have an 8am class Monday morning. This year, there is no ramping up to a full schedule--we start with it on day 1. Should be fun!

The last of the first

I finished my biochemistry exam a little before 11:30am this morning and it was the last exam of the first year of medical school. Time to sleep, celebrate, and then sleep.

Physiology Exam

Yesterday I finished my board exam for physiology. Many of the questions give little clinical vignettes about a patient and then ask a (sometimes) related question. Some of the more memorable patients presented included a college age man who had just eaten 100 bananas (he was trying to break the world record) and a 16-year old girl who was 18-weeks pregnant, drinks 2 beers a week, and just started running on her high school track team and was wondering why she was so tired. After the test, several of my classmates and I laughed about some of these characters and their presentations. The best part is that these patients are not in any way abnormal or exaggerations, in fact these cases are mild compared to what I've seen in real life in the emergency room.

Exam season begins

This week starts off our crazy 6-week long exam period beginning with our neruoscience midterm. Most of our exams, the National Board Medical Examiner exams anyway, are on Saturdays--4 of the next 6. Let the studying commence!

(I'm sure I'll be posting more here during this time as a form of procrastination. Stay tuned.)

Marfan

In our genetic counseling seminar yesterday we were discussing the clinical tests used to diagnose Marfan syndrome. The picture shows positive results for the two most common tests: the thumb and wrist signs. In class, the doctor asked us if anyone had a positive thumb sign. Everyone holds up their fists and there are only two of us with positive signs. She then explains the wrist test--not just wrapping your fingers around your wrist, but to be able to touch or overlap your index finger with your little finger--and asks again. Again, I test positive (very positive) and get to show the class. At this point the entire class is convinced that I have Marfan syndrome, especially "since you're so tall." They all had concerned looks on their faces.

It seems as if the self and group diagnosing part of medical school has begun! The funniest part for me is that I'd already talked to my doctor about Marfan years ago and despite the positive clinical signs, I'm fine. Though, it is entertaining to show off for the class all my crazy tricks. I think I'll save my leg hyperextension for another class.

Only the best

We had a guest lecturer in Microbiology today, a well-dressed man who spoke impeccable English. He's a pediatric infectious disease specialist and gave great information regarding viruses and their clinical presentations. After class, as he was headed out the door, I asked him if I could perhaps shadow him in his work or volunteer in his department. He said of course and handed me his business card, making sure to write his personal cell number on it. I didn't look at the card until after he was gone...he's the Rector of the University (Stateside, that would be the equivalent to the President of the school). Of course, I unknowingly ask the #1 person in the school to ask to shadow. Only the best for me!

As some of you know, I usually knit during class, but this fall in my free time I tried my hand at crocheting. I had a specific request from a friend for a Hobbes doll and just couldn't figure out how to knit one. Four and a half months later, this guy finally arrived on their front porch.

Hobbes Doll. Photo credit Cameron Booth.

I created the whole thing by myself consulting a few arigurumi patterns for body building and of course the comic strips for style.

Thought I forgot about you?

Ok, to be fair, maybe I did...for a little while. I had such an amazing holiday break that words don't do it justice. P & I were back in Canada at his mom's house surrounded by family, friends, and the warmest generosity. We made it back to Poland and have adjusted back into our routine with only a few New Year resolution-style changes.

We are both choosing to eat better and are adjusting some habits in our lives for the better as well. So far I've been impressed with both of our efforts and I think we may just be able to keep this up. Hopefully by the end of the month we'll have a gym membership, so we'll be able to add some exercise in the mix.

School will begin to ramp up soon as all my "exempt" classes come to an end. I am trying to build better study habits now before things go full swing and so far so good. By February, anatomy will end & we have the NBME exam, microbiology will be in high gear, parasitology will be moving as well as biochemistry and physiology. Throw in some genetics lectures and classes and the beginning of neuroscience and now we're talking. I am excited for this and am looking forward to having to work!

Snow 1, Chelsea 0

It's the Friday before break and all my classes have been canceled. Therefore, I'm officially on holiday. This would be pretty great if I weren't on crutches. Wednesday this week, as I was just leaving for school, I crossed the snow-packed street in front of my house and slipped landing on my left knee. It didn't help matters that I had about 10 kg of books in my backpack too. I managed to crawl back to the side and hobble back to the apartment. A trip to the doctor that afternoon didn't provide much insight except that my pain structure is abnormal for any of the typical knee injuries. I responded that I don't have typical knees.

I borrowed crutches from a friend, got a compression bandage from the doc, and he started me on 10 days of heparin. Why heparin, you may ask. Well, Monday I am getting on a transatlantic flight to head to Ottawa for the holiday break and, having a recent leg injury, may be at risk for a blood clot.

I am supposed to go back today, Friday, for an ultrasound to see if there is any soft tissue damage like a meniscus or ligament. After two days of staying off it though, I am feeling quite a bit better. I know I should go through with the ultrasound just to be safe, but I'm pretty sure they won't find anything. I have a feeling that in a few more days I may be back to at least 80%. That means no jogging for a while, but the fact that I fell just walking across the street means I won't be jogging outdoors anyway! It's gross out there!

Papers in order

We just returned from a whirlwind last minute trip to Gdansk to get P's new biometric EU passport. It means he is in the clear for leaving Europe next week and is the proud holder of two passports again. Now, this week, it's time for me to make sure I have all my papers in order. My resident card expires on Saturday and my new one should be in any day, though I have yet to hear from the office. I have to take a few hours on Monday to go and do some investigating and see if the decision has been made in my case and if my card is ready. Just more pre-holiday stress, something everyone needs more of, right?

Weekend update

It's snowing and sticking in Poznań! The place has turned into a winter wonderland. If I thought my cobblestone church-lined street was quaint before, it is downright picturesque now. The snow was a beautiful backdrop for our little and late Thanksgiving dinner. It was lovely with Turkey (parts, not a whole bird), mashed potatoes, 3-bean salad, wild mushroom stuffing, cranberry sauce, and a  homemade apple pie. We had a friend and her son over for dinner. The cats welcomed their attention and I welcomed their help in the kitchen.

It's going to be a big week around here as P starts his new job this week. Oh yeah, did I mention that he got a job?! I am so excited for him as it's at a really cool place and should be a challenging position for him. We are also starting to look ahead to the holidays and the prospect of a trip across the pond. We are not so excited about the new airline transatlantic baggage restrictions nor the scan/body search requirements as we transit through the US. That being said, I am still so excited to head to Canada for the holidays!

The Bells

One of the things I truly do love about living in Europe is that without looking at my watch I can tell you when it is 6am, 9am, 12 noon, 6pm, and 9pm. It's the church bells! We live across the street from a church and at those times there is just a cacophony of bells. They don't mess around with the 2 bells for 2 o'clock or 5 for 5 o'clock business. They just let them all ring five times a day. Even downtown, there are churches on every other corner and the bells ring out in succession across the city. It's a comforting sound to me. And a few times those 6am bells have saved my ass when I forgot to set my alarm!

NMBE Histology

In a couple hours I will go to take the National Board of Medical Examiners histology exam with my classmates. I feel fortunate that I received my histology education at Gdańsk as I see how unprepared my classmates are for this exam. I have been studying with friends going over material that has been purely review for me but has appeared to be new to them even at the end of the class. We'll see how the results will look.

As I have been surrounded by test-takers recently,  I realized that I've never been an exam freak-out person and for this I am very thankful. Somehow I seem to be able to keep my sympathetic nervous system in check and approach exams as games or problem solving rather than life or death tests. I recently listened to a Radiolab program that touched on this and made me recognize that this testing paradigm shift that I established years ago is extremely beneficial. When I've explained my test-taking behaviour to others, oftentimes they seem to assume that I am taking the material lightly or not being serious enough for the subject matter. I argue that if you stress yourself out with the material and/or situation, you will not perform your best and, particularly with medicine, if you do not preform your best there can be serious repercussions.

Ok, enough procrastinating, I have an exam game to get to.

Odd but true

It is illegal to perform a vasectomy in Poland.


Cue "Every Sperm is Sacred".

Anatomia

[Rant]
I'm in weird position at my school in that I do not have to take Gross Anatomy due to my previous courses from Gdańsk. Well, I don't have to take the course, nor the school exams, but I am responsible for taking the NBME exam (National Board of Medical Examiners) with the rest of the class and have therefore chosen to attend classes and labs as a way to review for this exam. And this is what puts me in a weird position.

Long story short is that I'm teaching half of the lab classes. I'm running it much like I had anatomy in Gdansk, asking everyone questions and pointing out notable structures. Several of the students have joked that I should get a salary because I'm doing more than many of the assistants. I try not to step on the assistant's toes. When they want to teach, I step back and let others move up partly out of respect and partly because some of them drive me flipping nuts! However, when something is unclear to the rest of the students, which is often, I will ask questions to clarify answers. I am usually respectful and even-tempered especially when it comes to working with assistants and professors, but I almost lost it today.

In order to be a good teacher you must LISTEN! Big Baldy, we'll call him, can actually give good informative if not slightly off-topic lectures that most of the class benefits from. He cannot, however, answer a single g.d. question and when he asks a student a question, he rarely understands the answer and will say you are wrong--even if you are right. A large group of us were working together to identify a part of a bone today. We'd offered many answers and were told they were all wrong. We were utterly stumped for a good five minutes until Big Baldy finally tells us what it was...which is what we'd been saying all along. I pulled him aside and said in my most polite way, "Sir, we have given this answer at least 5 times and were told that we are wrong. Why is it suddenly correct?" He shrugged me off and gave me a BS answer.

His partner today received the brunt of my wrath, unfortunately for her. She'd asked us again about a part of a bone, stating that it is a specific name...a name which is not in any of our atlases, textbooks, or recommended resources for the class but is found in the Polish atlas. I'd had it. How can you possibly expect to test us on names of structures that are not provided to us in lecture, are not in the recommended textbooks, and are not in the English atlases? I continued that if something like this were on an exam, it would be worth going to the professor and/or the dean with it. The English division professors need to know what our textbooks and atlases name things if they expect to test us. I understand her point that the structure is important, which it is, and our text states the importance without naming the different parts, parts that are 2mm away from each other. I was not mean, but I was short and very serious which flustered her more than I'd anticipated, but oh well. The funny part is that I won't be tested by the department, so if it's on a test, I won't even know.

[/Rant]
Taking a deep breath now. 

Last week our Sociology of Medicine professor, a kindly old man who has been with the university for 50 years and is affectionately known as Papa Smurf, took us on a mini field trip to the part of the building where he normally works: forensic medicine. We had just been talking the class before about child and domestic abuse and he welcomed us to the forensic hallway where they have displays of the kind of things they see. Some are photos, some are specimens or parts of specimens in jars, and there is even a full body that was found in a mummified state with it's two aborted (also mummified) fetuses--that's mummified as in very well preserved, not with the wrapping like the Egyptians. Everything was arranged thematically: stab wounds, gun shot wounds, skull fractures, illegally aborted fetuses (Catholic country = no abortions), etc...

For the sake of all I won't go into details about what I saw, but there were both interesting pieces and disturbing pieces. It was a conversation I had on the following Monday about the trip that intrigued me. One of my classmates is a Romanian American guy from California. He said that the mini-field trip had hit him pretty hard because his mother had tried to have an illegal abortion with him--coat hanger and all. For him it was strange to look at the fetuses that were aborted (some also killed the mother during or after the procedure) and realize that it could have been him (and his mom). I know plenty of people who were "surprises" or "mistakes" for their parents, but I'd never met anyone who actually knew that they had survived a botched abortion. As a parent in that situation, in what circumstance would you release that information? It's a situation and relationship that I've never encountered before.

A weekend off--not really

Friday afternoon we caught the 2:45 train to Sopot for a weekend full of family, friends, and unfortunately business. We're staying at P's cousins' place but P was late because he had to go pick up the key to our old apartment--we had got a call from the posters our friend put up all over town, someone wanted to see it and the owner's rep was super sick. He finally made it and we had beers and sat up until midnight chatting with the fam.

Saturday morning, P showed the apartment while I had coffee and caught up with friends. We met up and headed for his uncle's place to have dinner with his aunt, uncle, and grandpa. Dinner with this group of people always includes at least 2 bottles of wine and a bottle of something else, this time homemade fruit infused vodka, as well as a huge meal with coffee, tea, and cake. I can tell my Polish is progressing because I could participate a little more in the conversation. Bit by bit, I'm making progress. We headed back to the cousins' place and had to start taking care of business while slightly tipsy. The guys who saw the apartment would like to rent it and we have to work with the owner to come up with a satisfactory plan which meant a late night call to Canada. It's more complicated than it sounds, unfortunately, but we're working on it.

Today, Sunday, I'm meeting with a few more friends--ones who seem to be on the path to burnout with too much studying and I've been asked by other friends to try to intervene. A 19 year old isn't going to listen to anyone, but I'll give it a shot. It'd be an easier intervention if she was doing something bad, drinking too much or sleeping around, but it seems even studying too much can be bad for one's health.; everything in moderation, right?

The rest of the weekend will include: a giant party for P's aunt (where the wine will flow like water), a (perhaps drunken) phone call to Canada to arrange things with the apartment, a trip Monday morning to the old apartment hopefully to sign a lease with the new people, a trip to city hall so I can de-register that I live here in order to register in Poznan and get my visa process started. Then we'll get on a train for 5.5 hours and be home around midnight Monday night. Ugh. Here's hoping that all goes to plan.

Unpacking

We've moved so many times in the last 5 years, you'd think we'd be pros at this by now. The unpacking has begun in earnest. We (re)built the record shelf and the reshelving process has begun as well. Our bed is in place, though our headboard still needs to be unpacked and installed (it attaches to the wall, which will require purchasing a drill). The kitchen is almost done unpacking. It was a pretty complete kitchen, so we're packing up what was there and replacing it with our stuff. If I'm going to break a dish I'd rather it be mine!

The hardest part of unpacking so far has been the clothing. We don't have a lot of space for hanging yet and we haven't figured out a great storage system so most things have been living in piles around the house. It will get better with time and planning though.

School is in full swing and I am counting myself lucky that I received exemption from two of the big classes (anatomy and histology). I will still have to take the NBME exams, but my presence in class and lecture is not required. That frees up a lot of time to get stuff done. Yesterday, for example, we walked 30 min to get to the office to sign up for internet. We've signed up and received the modem but it may be up to 3 weeks before it can get installed! Here's hoping for a speedy installation guy.

And just when you think everything is going so well...the bad stuff. We still have not found someone to rent our apartment in Gdansk. The lease we signed did not have a clause to give notice to break the lease so we are legally responsible for it until either (a) we find someone to take over the lease or (b) the lease ends in February. Every lead we've had has fallen flat and we're having to post fliers around the schools hoping to entice some students. It's an extremely frustrating situation and, after having been through a very legit lease signing process with our new place, we realize at how we have been totally screwed over by our old land lady. The lease protected only her interests and none of ours. Ah, but we live and learn.

This weekend looks like it will be the last weekend of good weather for a bit which makes it even more exciting that I get to pick up my new bicycle tomorrow. Piotr is heading to the flea market and I am going for a bike ride. It's getting chilly enough outside that I need to find my bike gloves though--these long fingers don't work so well when they get cold.

Once we get internet, I fully intend to keep this blog updated more regularly even if it's just one liners. We'll see how it goes once I start to get buried in studying. You know what they say, even the best intentions...