Day 3217: The long road home

Greetings from Narita Airport in Tokyo, Japan!

I have been here for about 3.5 hours awaiting my connecting flight back to the Midwest. I walked around a lot, perusing my Duty Free shopping options. I ended up buying fun Kit Kat flavors, a coin purse, magnets, and this pretty framed artwork (below).

The flight from Tokyo to Chicago is roughly 17 hours! Oy vey. I plan to walk around as much as possible to keep the blood moving. I slept a little bit just now waiting to board so here is a parting shot from the airport!

See you in the States soon!

Day 3214: The future is now

AHHHHHHHHHH

Today is the day! Rank lists are due! At 9:01pm eastern standard time, my future was officially out of my hands. The computer has completed running the program that has decided where I will be trained as Dr. Jessica Lee over the next four years. 

CRAZY!!

And I don't get to find out until Friday March 20th! Torturous!

It's been nice to be here in Taiwan when all of this drama is going down. Being in a US medical environment would make this whole month too stressful. Everyone would ask "where is your number one program??" Over and over again. I would lose it. Probably stab someone with the nearest needle. So, just chatting with my friends via messaging apps is sufficient. I just want to make sure everyone ends up where they are supposed to be (and hopefully happy to boot).

Until next time!

Day 3200: Treatment room

This morning, the adorable old wise dermatologist I was supposed to work with was out sick. So instead of tagging along with another doctor/resident, I decided to go to the treatment room. I had the best morning.

The treatment room is comprised of injecting steroids to minimize scars (or keloids, which is an elevated discolored scar), increase hair growth (for alopecia), etc. There is also suture removal, opening and draining of infections (a dilation and curettage), and other things! I got to inject steroids in to gobs of people this morning. I also removed some sutures. Like I said, it was a great morning. 

Day 3199: A smattering of pictures so far

The hospital where I work most mornings

Perfecting my suture skills

My classmate and I at Zhinan Temple

One of the prayer sites at Zhinan Temple

Taipei 101 -- the tallest building in Taiwan

Guanqian Road near Shin Kong Mitsukoshi (a department store)

Day 3194: Medical education, a comparison.

USA: In the United States, teaching students is a priority. Medical students have a lot of autonomy to learn and do. The first two years typically have minimal opportunities to work clinically (seeing patients). If there are opportunities, they are usually shadowing (what it sounds like; following doctors around and staying quiet). Once third year hits, we are in the hospital all day every day. We deliver babies on ob/gyn, we suture on surgery, we see patients on our own on family medicine and internal medicine, there are a lot of responsibilities in being a medical student. The system requires that a student does, in order to learn. There are a lot of questions asked towards medical students in order to gauge their knowledge so that a physician/attending may teach.

Taiwan: There is very little teaching that I can appreciate. The clerkships look a lot like shadowing, at least here on dermatology. Students sit away from the patient, and as a result, they rarely get to see the problems the patients come in with. If students wish to see the patient's presenting problem, they have to stand up, stay out of the attending and resident's way, and try to catch a glimpse of the problem. Attendings rarely teach students, nor is there an exerted effort to show the students any of the pathologies seen on patients. "Any questions?" is a query often asked by the teachers, but very few of the students here ask questions. In dermatology, at least, there is at least a half-day of student "autonomy." Meaning, students see patients on their own, staff with/report back to an attending physician, and then they see the patient together where the attending diagnoses and treats the patient. I can't believe it's only a half day! We do that all day every day starting day one of third year!

Obviously, this system is disparate from what I learned in the states. Nevertheless, there are probably pros that I have yet to realize or discuss. Anyway, just wanted to jot down some thoughts I've had so far.

Talk soon.

Day 3191: Bonjour Fevrier!

Okay, so, I still suck at blogging so far in 2015. But. I hope to blog between work days because (drumroll please) I am in Taiwan! I am on a dermatology rotation this month. My first day so far has been quite crazy. My classmate and I showed up to orientation at 9am, we signed a bunch of forms, received our IDs, and then were thrown in to derm clinic. Honestly, thrown in. We walk in to this clinic room and it is stuffed with white coats; another visiting student from New York, a current Taiwanese medical student, two residents, an attending, oh, and the patient. The two most pressing observations are as follows:

1) The patient could care less that there are six white coats in the room. In America, the patient is already annoyed at having to meet more than one white coat in sequence. You better believe a patient would abhor a room full of white coats. Especially a room full of white coats where half of them are not even participating in the discussion with the patient.

2) Doctor versus patient location. In Taiwan, the doctor stays in the room and the patient is called in, one at a time. It is a revolving door of patients. Compare this to the US, where each patient is roomed separately and a doctor runs among his/her different rooms to see each patient. In Taiwan, it is more efficient to see each patient as s/he comes in. 

After a full morning of clinic, my classmate and I finally have our orientation with our resident/contact person for the month. It's a diverse mix of inpatient dermatology, outpatient/clinic, and surgery/procedures

It has been a full first day! Clinic, orientation, consults. And LOTS of Mandarin!

More tomorrow!

(Note: The titles (Day xxxx: ...) for this month are a little off! I am writing based on Taiwan date and time so it is 2/2/15 as I write this! The future!)