Sunday, November 22, 2015

Mission accomplished!

Well, its been completed. I'm officially a physician in Germany!

But let us rewind a bit first. About 5.5 weeks ago, I had my last day at work in Hildesheim. Apart from a little trip to Ludwigsburg right after that and a weekend in Hamburg babysitting my godchild, all I did was sit at my desk and study. Since I only had about 4 weeks, I didn't leave a day out to rest. The time flew by.

Sleepy godchild

cozy sunday

I started with 5 days of urology, thinking it would be a nice ease into studying again. I continued with surgery before moving on to internal medicine and neurology. For some of the professors, protocols from previous exams existed that helped narrow in the topics they ask.

The other two examinees and I also personally introduced ourselves to the professors ahead of time.

Neurology was probably my biggest trouble child. Its just a wide field of information for a specialty I hadn't exactly spend much time in. (To make things even more exciting, the neurology professor was switched 4 days before the exam date.)

my too-cool-for-school study buddy

My mood kept swinging between "Viktoria, you've totally got this!" and "Oh F**k. I don't know ANYTHING!". I spent a lot of time talking to myself out loud and explaining all kinds of diseases.

Knowing enough information to pick the right multiple choice answer is just something else from being able to explain a disease to someone else in coherent sentences. 

When I did take a break, it was either to take my aunts dog on a walk to clear my head or I skyped.

Day trip to the European Bread Museum

The other students in my group had about 3 weeks of more studying than I did. This is totally my own "fault" since I took my days off during the year. I don't regret that one bit though. Those vacations all over the place were worth every minute and cent. In the end, who knows if that what I could have looked at in those days would have then been asked in the actual exam.

study break

I was never really nervous about the exam (except a little bit the morning before the second day). I can't decide if I was really good at suppressing those feelings or if I just had given into the situation I was in. I couldn't change the fact that I had to go through with this exam, so why stress? Instead, I decided to use my energy to get more studying in. My biggest thing was, I didn't want to have put in so much work over the past 6 years and then look like an idiot in front of the patient, the four professors and the other students. I know my strength is in the doctor-patient-relationship. I know what is practical and necessary to know but I don't get hung up on absurd details. My brain has too many other interests for that space to be occupied by exotic facts. Nonetheless, in the exam situation, it doesn't really matter how many other great hobbies you have, how much other knowledge in other fields you posses, its all about medicine and the doctor situation. 

The weekend before my exam, I temporarily moved into a more or less empty apartment, that belongs to my aunt, in town. I spent two days in the kitchen with nothing there to distract me and looked at my notes. It was really productive. 

My parents spent that weekend at a huge 3 day long party at my dad's fraternity (they were celebrating their 125th year existence). I received a motivational call from them the night before. A few friends of mine, the ones that knew I had the exam the next two days, sent my good luck wishes. I spent about two hours prancing around the apartment listening to uplifting African music. I needed to move, I needed to dance and get out of breath a bit after sitting for so long.

I had a few nightmares the weeks leading up to the exam in which I overslept or couldn't find where I had to go. The night before my exam, I slept quite well. I got ready in the morning and headed on my way to the hospital.

Day 1 Exam:
8:00am: received our patients names and wards from the committee chair
8:00-9:00am: interviewed the internal medicine patient and performed a whole body examination
9:00-9:20am: interviewed the surgical patient and performed the relevant body examinations 
9:20-11:50am: looked through all the files and wrote a release letter for the internal medicine patient
11:55am: release letter drop off
12:00-1:45pm: trying to look at as much relevant information to the patients diseases as possible, stuffing a sandwich in me and following it up with a coke for caffeine, sugar and fluids. 
1:45-4:50pm: all four professors and all three examinees went from one patient to the next, starting with the internal medicine patients, and each examinee was allowed to present their patient and was asked questions for about 20 minutes.  

When we were given our internal medicine patients in the morning, we all tried to hide our shock when they ended up all being some rare cases of cancer. I had studied a lot of oncology before the exam, my patients diagnosis was not one of them. To top it off, the professor said my patient had some nice neurological side effects to show and be asked about (ugh!). Luckily, the professor said he wouldn't ask details about the rare disease specifically but rather the broad spectrum of similar diseases and relevant information.

Before even looking into the files once I got them on the ward, I went to talk to the patient. I wanted to hear it from her first hand. She was a very nice lady with a very positive view on her situation. The dynamic between us was great. We felt like a team that would get through this exam together.

I was relieved when I arrived on the surgical ward to find my patient only having broken her ankle. Rather simple case. Young girl, broken ankle, typical fracture, no comorbidites. 

I quickly got to the library and started looking through my first patients files. She had a rare manifestation of a B-Cell-Lymphoma. It took a while to go through all the files and put together a coherent timeline of the events. Once that was done, the task of writing a letter with a good flow was much easier. Once the letter was dropped of, I tried to stuff as much information as possible into my head and as much food and energy into my stomach. 

I was the first one up to present my patient and get asked questions. My first few sentences probably sounded as though I was a bit nervous. I just had to get into the mode of actually talking after having spent the last few hours cramming information and not talking. The first patient went alright. I was allowed to show some examination procedures to the professors and more or less could answer all of their questions. 

While the other students presented their patients, I tried to answer the questions they were asked, in my head. Most of them I could. Others I didn't have a clue. 

The second round was with the surgeon. I had hardly spoken the first two sentences before me interrupted me to ask questions. I was prepared for this since the protocols of previous exams all mentioned that he did that. He was a cool professor to be questioned by. He also threw in some fun facts to lighten up the mood. I was done before I knew it and then only had to deal with my back hurting while standing through the other 40 minutes of examining. 

I was glad when the day was done and was content with how it had gone.

My parents, uncle and grandma stopped by that night to bring me some food and say hi. It was great seeing them and being able to report about the day I had had.

As mentioned, I was slightly nervous the morning before the second day. This was mostly due to the way the neurologist asked questions the day before. She asked some specific things that I hadn't dealt with either at all ever or since the lectures. 

We were all dressed up and ready to go. The second day took place in the oncology meeting room. One side of the room the professors and on the other side of the table, us three students. 

I was once again the first to go (ladies first) and started off with urology. It went well and I was feeling fine. After the first round, the committee chair offered us all some coffee. 

My second topic was surgery. That also went well. 

At this point, I had calculated that my next topic would be internal medicine, leaving the one thing I wanted done and over with for last....neurology. Not only was it my last topic, but I also calculated my topic. She was asking major neurological cases in the emergency room. The first guy had meningitis (man, I would have killed that round of questions) and the second guy had stroke (also a topic I felt confident in answering). So what was left for me? I would have put money on it and would have won......epilepsy. Great........ugh. 

First, I still had internal medicine to complete. There was no knowing what topic he would ask. The EKG interpretation went well and the case scenario did as well.

Last round and last topic for me: neurology. Of course, she started telling a story about a patient and it fit 100% to epilepsy. She didn't go extremely into any details and I was actually able to answer all of her questions. 

And with that, I was done and only had to wait the next 30 minutes until the other two had their last round behind them. We did take a break in between and the coffee ran right through my system so I had had to pee really badly for about 1.5 hours. As soon as we were out of the room so that the professors could discuss our grades, I ran to the bathroom. I was relieved to see that the other students and the neurology professor did the same. Apparently neither of us wanted to be the one to ask for a break in between. 

They asked us to come back in and gave us our grades. I'm very content with the result. Its exactly how I would have given the grades had I been the professors. I was happy it was over and I was even happier to get out of there and get to my family. 

While walking down the hallway with the surgical professor and the other students, my family crossed our path looking for the meeting place. So the hugs and congratulations took place right then and there. 


We drank champagne, took pictures and since I wasn't the only one who had passed, I congratulated the other group as well. My family and I went out for a lovely dinner that night, followed by drinks with some of my urology colleagues. Since all of my close med school friends don't have their exam until after mine, we have to push the crazy partying back a bit. 

In the end it wasn't all that bad. I'm happy I didn't get crazy nervous or regret that I didn't have more time. The four weeks of non stop studying were necessary (even if it was mostly to feel like I was just doing something) but I wouldn't have changed anything about it otherwise. 

I don't feel much different. Its nice to not have the pressure of the exam weighing on my shoulders but I still won't be just chilling for a while. The day after, I made a list of things I had been putting off and the list didn't seem to stop. I organized all the things I had to do now that I'm not a med student anymore. I was a bit overwhelmed at first and decided I didn't want to be an adult and wanted to sign up for the first semester of a different field right away. Student life is rather simple in many aspects. But I've organized a lot since then, had some informative meetings and am a bit more on track with my new life now.

I spent a few days at the lab. I need a few more slides looked at before the work that needs to be done with me physically at the lab is done. Then its time to write my doctor thesis. It won't be long before January gets here and I start studying for the USMLE again. 

As you can see, my to-do list is far from finished. But it never will be finished, I'll just be crossing things off of it while new things get added. Such is life and that is good.

So for now (don't worry, I'll be back soon, so stop by occasionally!)

Become a physician

If I'm ever lost....I can always just go here.

Stay healthy!