Friday, May 23, 2008

Real People

So today was my first day of actual clinic activity. Last Monday, we had a brief intro to the computer system as well as a tour of the clinic. The true unfortunate aspect of this entire experience is that nobody seemed to know what was going on. I was assigned to a D-3 that had no idea I was going to be hanging around her all morning. So really, depending on your partner, the patient, the chair (some are harder to fit an assistant than others).. made the experience great or meh.

Mine was ok. I experienced the less enjoyable aspects of clinic life as our patient showed up late and needed new radiographs. So by the time she was back in the chair (11:30), there wasn’t enough time to do much else aside from take impressions and the extra/intra oral exams. I didn’t get to do anything this time around. We were in the clinics as part of our periodontics class this semester. We have to observe, help out, and send a reflection to our instructors. We also have another component of the Comp Care class that will have us doing a LOT more in the clinics (at least hypothetically).

Despite not getting to do much, I did enjoy interactions with REAL people. Schmoozing is not my greatest attribute, but I definitely was more personable with the patients than I expected to be. They get left alone so often because the student needs to CONSTANTLY get checked off by the instructor..so they spend half the day standing around an instructor waiting to grab them once they are available.

Most of my use was keeping the patient company while the student was off searching for an instructor. Just basic chit chat. The patient next to me actually was getting treatment done that I would have been able to really appreciate – an amalgam. It was awkward watching the patient squirm and vocally protest to the anesthetic being applied..but that is something I will just have to get used to. They also couldn’t apply the rubber dam because she would gag. I never even thought about how unpleasant that thing could be if you are working on the posteriors.

Too tired really to say much else. This first week has been a bit of a blur…and a lot tougher than I was hoping. I pray that is just a side effect of it being ‘the first week.’

I’m going to go cuddle up with my dental decks now, before enjoying some nice 3 day weekend. I’ll update what my schedule is like once I actually figure it out myself.

Sunday, May 18, 2008

Back In I Go

So tomorrow D-2 year begins with a wonderful summer semester. The schedule looks much lighter than last semester (mainly because we are doing far less lecture-based material and more lab/clinic). I would gladly stay at the school for a few hours longer each day doing lab work with the freedom to come home and relax rather than get out early and have to study all day. Unfortunately that won’t be the case this semester with all my board review materials to go through.

Who knows how it will actually end up. I will do the schedule breakdown later, but we have far less credit hours and the summer is thankfully a shorter semester (12 weeks as opposed to 16ish). However, we really don’t get any time off to prepare for the boards. I will be taking them between this summer semester and fall. We get 2 weeks off in August and hopefully I will manage to prepare enough to do well.

The board exam is apparently changing to pass/fail in 2010 which will render it a useless tool in acceptance to post-doc residencies. I still want to do well on it for my own perverted sense of accomplishment. However, much like my grades in general, I won’t be upset as long as I get through it and do my best. This attitude has worked out throughout my educational career so I may as well not attempt to change now.

I noticed that mid-May is already upon us and all the new applicants are climbing out of the woodwork and being insane. I almost can’t look at the forums anymore because pre-dents are so damn obnoxious. I can’t help but laugh though, because we all have gone through it and have had those same phases. I also remember how much waiting is involved from the day you fill our your AADSAS application to the first day of class..15 months or so, a long time to just sit around with your life essentially on hold.

I am excited for the D-1s to show up in August so that I can see how happy and eager I looked a year ago. It will also serve to reaffirm the obvious fact that I am a year into this educational path and just that much closer to being done. I spent a lot of time with friends of the non-dental persuasion over this break. They are living life in the ‘real’ world, working, making money, getting married and doing all the things young college grads do. I feel stuck in educational limbo. I still couldn’t see myself anywhere else though.

You grow up a lot in a year, especially in a program like this. The scary part is that you still don’t know anything and treating real people is going to be quite a new experience for all of us. As much as lecture halls bored me, at least it was well within my own comfort zone. Getting to interact with patients while attempting to learn new skills will be quite interesting indeed. Granted, we won’t be getting our own patients probably until next spring, but we still will be treating.

So I’m going to pack up my bag and hit the sack. Tomorrow is going to be an orientation day for all the new courses as well as a tour of my group practice. Should be interesting..hopefully learning how to use axium (computer record system) won’t be as boring as I think it is going to be.

Summer is finally here. I’ve lived in Chicago for a year. It feels like I just picked up my degree from undergrad a week ago.

Time flies when you are busy as hell.

Monday, May 12, 2008

The D-1 Experience V

With the D-1 year officially completed, I figured I would provide one last post as a sort of summary of what the first year is like. Mental stamina is probably the most important skill one must possess to be successful. You need to grind out studying night after night once the semesters get rolling. There really are few ‘breaks’ during semesters. It is emotionally draining to spend 9 hours away from home, only to return to books and power point lectures. Nothing we learned this year was what I would call ‘hard.’ It essentially is a chalk-full bag of basic science. BASIC being the key word. We are simply expected to cram a bunch of minutia, pass the classes, and then remember enough to pass the boards. Once we get beyond the boards, we will proceed to forget 95% of the things we studied so hard for – a testament to the gross inefficiency of professional education (it ain’t just dental schools).

HOWEVER, the relevant information we did learn WILL stand on its own. The actual dentistry related courses were sparse this year, but useful and relevant to the career we all have chosen. However, I often felt isolated from dentistry in general as I was stuck in a lecture hall memorizing how fatty acids are synthesized or what a cross section of the spleen looks like. Don’t get my negativity wrong either, some basic science is essential for you to be a functioning individual in the world of human health. However, it felt like a smorgasbord of random facts as opposed to concise and relevant information. Most of the courses overlapped as well and course directors definitely do not communicate with one another. I don’t know how many times I was forced to sit through a lecture about respiration in different classes…the same information rehashed by a different professor.

We are going to apparently get some clinical experience the first semester of our D-2 year, which is frightening and exciting at the same time. I am not prepared at all to deal with live patients, but I would gather most of my peers feel the same. You can talk about treating patients until you are blue in the face, but it isn’t until you get in there and work with them that you will actually develop and learn. I will delve into this as the D-2 year gets going.
Many upperclassmen say the first year sucks the worst, while others argue that second is harder. However, it seems to be the general consensus that third and fourth years are MUCH better.
So for all the type A’s out there…I know most of you reading this fall into that category:
D-1 Summary:

First Semester –

Straight-forward and fairly easy; the only challenge is gross anatomy and this class probably is most important as well once you get into head and neck. Micro, physio, and histo are all manageable for anyone willing to put in a bit of time. If you have taken these courses in undergrad, things will be a bit smoother (but don’t expect free A’s).

Human dentition is a very important course and you will probably learn a LOT more than you expect (even without noticing right away). Wax-ups WILL eat up a big chunk of your time. If your school provides you with a torch, take them home to do work occasionally, it helps.

Any other dentistry related classes will be introductory at best. We were only cutting class I preps on the mandibular 1st molars by the end of the semester. The only real challenge is reminding yourself that it is OK to not be perfect right away.

Even more important than class itself is not alienating yourself from your peers. You will be spending a LOT of time with these people over the coming years. You aren’t all going to be best friends, but it isn’t that difficult to be courteous and friendly to everyone. School = stress, which often turns people into cranky, paranoid, and delusional douchebags – so don’t become one of those. You will be surprised how many close friends you make and even more surprised at how fast you make them.

Adjustment is also a key point. This semester is much lighter than the second, so getting into a ‘groove’ or study pattern NOW will save you a lot of trouble in the future. Finals are a royal pain the ass – but get through them you will.

Second Semester –

Much tougher in comparison to the first semester. More classes, more pre-clinical activities, plenty of useless requirements with mandatory attendance. I was disappointed in that much of our pre-clinical restorative classes seemed wasted on procedures we were not equipped to do (composites without any tools meant for them for example). We also did sealants and liners and other things we won’t be doing again for a year or so. I would have rather spent this time cutting and filling preps. I would rather learn a few skills really well than many skills poorly.

Which brings me to something different this semester, you will be coming into the school a lot more to work on pre-clinical activities like restorative. I came in quite often on weekends to practice and I’m not amazing yet, but I am happy with my work at this point. Learning the hand skills part of dentistry is the same as studying for an exam, you have to go over the motions again and again. What makes this hard is finding time. It is easy to lose sight of why you are in dental school when you are swimming through piles of biochem handouts. MAKE time for your pre-clinical work.

Biochem was the biggest bitch of a class I have ever taken. It was not the hardest at all – but it was so so very difficult to focus on. It requires a LARGE sum of time to do well and the material is absolutely dull and irrelevant (for the most part). We had 5 lectures a week and 7 exams (including a cumulative final). I just remember the mental agony of trying to study for these exams and wanting to jump off my roof each and every time.

Physio and histo were about the same as last semester. Gross anatomy was short for us and finished in February (it still was tough..but not nearly as bad as last semester). Neuroanatomy was another class I struggled to study for.. outside of the relevant cranial nerve and pain management info..most of the class felt too detailed for me to care about. This class could probably have been merged into gross anatomy because I have heard it isn’t hammered very hard on the boards in the first place and there is no way the questions will be as detailed (I of course can retract this uninformed guess after I take the boards).

Occlusion was interesting, but a bit confusing at times. The lab work also required too much free time while struggling with all the other courses at the same time. The first half of the semester was much more organized lecture-wise. I was lost after the midterm. The wax-ups were quite possibly the most frustrating experience of the entire D-1 year. Getting those perfect tri-pod contacts while maintaining an esthetically pleasing wax-up is an exercise in futility unless you have done it MANY MANY times.

Pathology started out being the best course of the semester but quickly faded into a cram-fest with lectures that were just too damn long. I would rather meet 3 times a week for 50 minutes than once a week for 2 hours. Next semester we meet twice a week for 2 hours each…ugh. At the least the tests themselves were quite manageable and geared up like board questions.

Radiology was great for the most part. I actually enjoyed the material and wish we could have made this course worth more than 10% of comprehensive care Ib. Given how important this topic is, I am surprised we don’t get more training. I haven’t looked at the schedule beyond this summer though..so maybe we will get more.

This semester is just a marathon of studying. However, you can do just fine if you are good at managing your time and are an efficient studier. It is also VERY nice to get a spring break tossed into the semester to recharge the batteries.

Finals…oh where do I begin? This was the greatest academic challenge I have faced in my entire life. We had 12 total exams in 2 weeks (3 of them being performance exams). It is VERY difficult to juggle multiple topics at once but I had no other choice.

Honestly, I am not going to try to put this into words. It is an experience that I would rather not remember when looking back on these posts years from now. Unless you actually go through it, you won’t be able to relate anyways. You don’t WANT to relate to this either, so we will leave it at that.

They sucked. But I got through it, and many have done it before me, and many will do it after me. Well done to all that have. Have a beer or 10 because you’ve earned it.

2nd semester test count!
Practicals – 2
Quizzes – 32
Bullshit Papers – 3
Performance Exams – 4
Written Exams - 26

Conclusions:

The first year is mentally exhausting. You are constantly struggling to cram for the next random test and equally struggling to motivate yourself. Finding motivation to study for something as irrelevant as biochem is more challenging than you might expect – especially after sixty-some lectures.

The first year is also frustrating because you are ‘new’ to the school and a freshman all-over…for the THIRD TIME…bleh. You are pretty much viewed as an ignorant idiot by everyone at the school..which is somewhat fair..because well.. you are.

Another unique aspect is that you are getting used to the community of dental school. You are stuck with the same people day in, day out, for everything…EVERYTHING. They say it is a lot like high school, and I disagree. In high school, you had different classes with different people. In dental school, you have the same classes with the same people 8 hours a day, and no summer vacation.

It is like lord of the flies with hand pieces.

All right, this sentimental rambling has gone on long enough. Seeing as I haven’t had any second year experience, I will save difficulty comparisons and stress levels for the future.

As shitty as things get, you will have your good moments as well – and the time goes by REAL fast. I still feel like I started this blog a few months ago and it’s already been about 1.5 years. My, my, I will be graduating before I know it.

Apologies for late email replies, I am just finally getting back into a normal circadian rhythm.

D-1 year = Fin

And so begins my life as a D-2…crap.

Thursday, May 8, 2008

The Final Procrastination

Eleven finals down, one to go. This has been the most intense 2 weeks of school I have ever really gone through. It is difficult to compare to anything else because you get so numb to studying all day that you don’t even remember ‘normal.’

The plus side is that I have done pretty well, the verdict is still out in a few courses, but I should be doing about the same as last semester if not better which is plenty good enough for me and definitely not closing the door for specializing in the future (although I am most likely going to go general).

All that is left is histology, and I followed my own advice from a previous post about nailing the first few exams so I have a lot of leeway. Of course, bombing a histo test is pretty easy if you don’t study so I definitely can’t slack off THAT much. However, it is nice to know there is only one left and I survived everything while maintaining my sanity (most of the time).

Back to that post, it really does make a world of difference if you know you have some wiggle room on finals. It lets you allocate time where it is needed and minimizes pointless studying.

Finals week and studying is very much like trying to push back the ocean with a broom. There just is not enough time in the day. You need to study one topic for an hour, jump to another, and another, and so forth. I can’t emphasize enough how important it is to do well in classes BEFORE finals.

I survived so far…and don’t foresee a massive choke on histo, but stranger things have happened. I have been working on a final post about the D-1 year, so you can all look forward to that sometime next week.

I apologize for being lazy with emails, I hope to get better next semester.

Good luck to anyone taking finals and to all the new applicants.

Back to the table of knowledge I go

Monday, April 28, 2008

Finals Keep The Man Down

Just a quick reminder of why I am busy and have no life outside of school. However, there is a tiny glimmer of light at the end of this first year tunnel... but a lot still needs to be accomplished. The D-1 you have all come to know and love will soon graduate to the next stage of hoop jumping and gopher running...D-2 year. But more on that later.

Final 2 weeks = 12 tests total

This week:
Restorative written final (done today)
Restorative Performance Exam (tuesday) - class II prep on 30, class II amalgam on 31.
Neuroanatomy Practical (Wednesday)
Radiology Final (Friday)

Next week:
Physiology final (monday)
Occlusion final (tuesday)
Occlusion performance exam wax-up (tuesday)
Neuroanatomy written final (tuesday...this day clearly sucks)
Biochemistry final (wednesday)
Pathology final (thursday)
Perio written final (thursday)
Histology final (Friday)

I am feeling drained, yet surprisingly motivated to actually study and not blow all my grades at the very end. Let's see what happens.

Back to work I go.

Tuesday, April 1, 2008

21 Days Left Revisited

I said it was going to happen, and now seems a better time than any (I’m on spring break…finally). Last year I made a post towards the end of my undergraduate career listing 21 things that I would not miss after leaving undergrad forever. Now I feel the urge to re-create that sentiment except in the opposite..things I DO miss.. I’m sure these aren’t unique to me…well some of them may be. In no particular order….

21. Dominoes cinna-stick
20. Being able to leave my apartment over the summer and come back with it magically cleaned
19. Green grass and lots of trees
18. Teachers that know my name
17. Not feeling guilty about watching tv at night rather than study biochem
16. Porch sitting with scotch and cigars
15. Stoner friends (nicest, most un-judgmental people on the planet)
14. Having to go to school for 2 hours on some days or having ENTIRE days off in the middle of the week
13. No 8 AM class every day
12. Classes that grade on more than a handful of multiple choice questions
11. Comparatively no responsibility
10. Dominating all the freshmen when I was forced to take BIO I my senior year because I skipped it
09. Being able to go out with friends without planning it weeks in advance
08. Coming home and drinking a beer instead of cracking open a text book
07. Hot Shots Golf with the Cuz
06. Having time to commit to an exercise regiment
05. Having time to get groceries
04. Extra-credit
03. Feeling like the big fish in the bowl
02. Seeing different people every day
01. Having time to clean

Ahh to be one year younger. I do recall complaining a lot about being bored and ready to get out, and I’m glad it is over still…but damn – you really take things for granted until they are no longer available.

This will most likely be my last post until after the semester. Not enough to really add and the schedule is going to get brutal quite fast. I will recap finals and the D-1 year as a whole in mid-may. I will continue to answer as many emails as possible but again…they are not high on my list of shit to get done.

And so on and so on and so on.

Friday, March 21, 2008

The D-1 Experience IV

About 80% of the way through my first year of dental school – and it is time for another reflective installment as to what the first year is all about.

I would like to emphasize that you don’t really feel like you are in dental school most of the time. I am serious. I feel like a grad student of some sort just taking more biology courses so that I can get into dental school. Most of my hours are consumed memorizing signaling pathways for post-translational regulation, or memorizing what the spleen looks like both grossly and microscopically. I understand that we need to be competent health care providers, but am I honestly going to remember 95% of the details I am tested on? The answer is no. All of this first year feels very similar to getting into dental school in the first place - an arbitrary series of hoops to jump through, a rite of passage, whatever. I would be horribly screwed if they put in me in a room to even talk with a patient let alone diagnose anything. Granted, we haven’t taken any courses on patient management yet, but I don’t know how biochemistry will help me recognize caries. All of this studying also dampens your social skills. I feel a bit isolated, in a bubble of factoids and dark rooms with giant projectors. I really wish I could get out more, I hope I remember how to say hello and smile when I start treating real patients.

Again, this is all complaining, and I am downplaying how much I actually HAVE learned. Many things that are so natural now were completely foreign a few short months ago. The hilarity of saying “you got some spinach between 9 and 10” never ceases to amuse. The dental material we have learned so far HAS been quite interesting for the most part - cutting preps, placing restorations, taking gingival plaque indices, and just getting a feel for the many instruments. I wish we spent more time doing that stuff, and my prayers will be answered D-2 year. Granted, I am much better at traditional lecture based classes (because that is all I have ever done), but I enjoy the dentistry aspect so much more..despite struggling in comparison.

In another note, dental radiology is pretty cool. They unfortunately cram too much into our once a week lecture. I am far more interested than I thought I would be, which is great – the lecturers are very engaging as well. I remember bringing my own radiographs in for comp care last semester and wondering…what the hell can you get out of this? It is pretty amazing how the little subtleties and landmarks glare out after a few short weeks of lecture.

Another note is that you are bound to get tired of being the ‘little guy.’ The sterilization people are not the friendliest of people, especially to people that don’t know all the rules. Communication between sterilization and the instructors is also not so hot as we have gotten yelled at for not returning instruments we were told to keep all semester…sigh. It has gotten better, and I haven’t personally had any issues, but I still feel like a lost child sometimes. And yea, setting up your operatory becomes easier, cutting preps becomes smoother, and putting the damn gown on by yourself becomes second nature. Despite all of this, you still feel completely helpless most of the time.

All of the upperclassmen claim how great it feels when the next batch of newbies arrive…I will be taking my board exam around that time too..I can imagine I will feel MUCH older. I coincidentally turn 24 right at the end of august as well, how appropriate.

So at this final stretch point, motivation is the only real road block towards success. There is a lot to do, and time is not abundant. The looming glare of finals also creeps ever closer. It is also fucking snowing and April is one week away. C’mon! I mean, I’m not surprised because I have lived near Chicago most of my life, but you never really get used to it.

So as boring as some of this material can get, it behooves you to pay attention and retain as much as you can. The only reason we take most of these classes is because there is a board exam that is required before one can advance to patient care. Did I mention this exam has changed in the last year or so to be harder (in my opinion). I plan on keeping an NBDE I log when I actually start studying an earnest, but it will suck. I have 3 review books and the dental decks just staring at me from the across the desk…whispering…taunting…NO!

It is just one subject after another this semester, no breaks. Just finished a histo exam, so now I get to celebrate by cramming biochem all weekend. Finished physio last week, treated myself to reading a bunch of required articles, studying for three quizes and the histo test I just took. You get the picture. You really DO get used to it though - which is all the more depressing. But my dad put it best one afternoon while at lunch - "At least there's an ending." SO TRUE! Some people are stuck in terrible jobs their ENTIRE lives. I have to sacrafice some of my youth consumed with basic science...it really seems a small price given how truly wonderful dentistry is as a profession. This train of though keeps me going through the dark and snowy spring.

Wow, 2 posts in 2 days. Give me a medal. Back to biochem I go….last thing in my way before a week of total bliss.