Category: Years 1-2

How 18 Days in Kenya Changed My Perspective of Medicine Forever

Samantha Baxter, OMS-II

Participating in an international outreach trip as a medical student who just completed her first year seemed a daunting prospect at first. Pathology had barely been introduced into our curriculum and pharmacology was as unfamiliar to me as a foreign language. I worried that I did not have enough of a knowledge base to be very helpful to the people of Masara, Kenya. Armed with my physical exam tools and a suitcase full of medications, I joined eight other students at the Bonyo’s Mama Pilista Clinic to help serve the community to the best of our ability over the course of our 18-day stay in Kenya. 

After arriving in Kenya, we were struck by its beauty and the kindness of the people welcoming us to their country. The lifestyle was so relaxed that it gave us a chance to adjust without the pressure of overcoming jet lag. Our first day at clinic was a Monday, giving us a few days to review our exam skills and OMM treatments that might be useful for the population of patients we would encounter in the upcoming days. The excitement of being able to work with real patients kept me from sleeping the first few nights. I could hardly believe that in a few short days I would be able to make a difference in the lives of the people around me. As an osteopathic medical student, I was acutely aware of the differences in culture between myself and those from Kisumu, and therefore tried to soak up as much Luo (the local dialect) as possible before my first day. Morning runs to Lake Victoria gave me a chance not only to keep myself well-rounded but also the rare opportunity to glimpse locals at their jobs and the natural beauty of a lakeside city. 

The thing that struck me the most about my time in clinic was the simple victories that medicine affords not only the providers, but also the patients. Every day that we saw patients was the opportunity to make a difference in someone’s life. Over the course of our trip, we welcomed over 500 patients. The experience that stood out to me, was an older woman who came in too weak to stand. A neighbor who spoke English sat by her side, patting her hand and translating back and forth as I asked her about her symptoms and performed my physical exam. The simple kindness this neighbor displayed spoke of the strong bonds present in the community. My patient had collapsed outside three days before and had since been unable to eat or drink anything. All her symptoms pointed to malaria, so I admitted her to the clinic after her rapid test came back positive and helped the nurses start her on fluids and treatment. The next time that I saw her was the next morning as the nine of us were completing rounds with the doctors, nurses, and clinic director. Where she once was quiet and barely responsive, she turned to survey all of us from her cot. I asked her, with the help of a translator, if she was feeling better. She took my hand and told me “I feel much better. Thank you so much for helping me.” Those simple words were the greatest gift that I could have asked for. Later that day, my patient was up and walking and came to sit next to me during a short break. A translator helped me to understand more about her and her daily routines. The emphatic gesturing during her stories and the bright smile she wore warmed my heart. A day before, this woman was barely able to lift her head in response to my prompting, and now she was telling me about her family. Like many people, I chose to pursue a career in medicine from a desire to help others, but up until this point I didn’t realize just how large an impact doctors can have on their patients. What seemed like a simple solution to a clear problem to me made a world of difference to her. That experience is one that I would not have been able to have if I hadn’t chosen to go on an outreach trip with DOCARE.

At an opportunity to attend church in Masara we were introduced to the community. The welcome that we received and the gratitude we were shown demonstrated how important this mission was to them. Some of the members of the village would not have been able to receive care without these trips to the clinic. I walked from the church back to the clinic hand in hand with some of the local children, a few of which I had treated myself. Their excitement to show me their games and houses made me smile and appreciate my surroundings even more. These were real people, with real problems, that came to the clinic at their lowest asking for someone to help them. Each day we shared chapati and tea for lunch with the translators and learned about their hopes and dreams. Every experience in the village and the clinic taught me to appreciate the patient as a whole person in a way that I am not sure I would have learned without the opportunity to take this trip. I learned the importance of a kind word and gentle touch to make a connection with someone who is scared and doesn’t understand what is happening to them. That kind of experience can’t be taught. It is part of the art of medicine.

I am eternally grateful for the opportunity to participate on this mission to Kenya. My perspective was forever changed by the small difference in the lives of the people of Masara that nine American students were able to make. Though I have always been interested in global medicine and outreach programs, I could not have predicted what a profound change it sparked in me. I learned the importance of meeting your patients halfway and treating them not just as a case, but as a unique individual. The necessity of working as a team with limited resources brought all of the student doctors closer together and demonstrated how a unified approach is invaluable to medical care. It is my hope that I will one day be able to return to Masara as a practicing physician and be able to once again donate my time and skills to help the wonderful members of the village and community of Masara.

Hey ya'll! I wanted to share an essay/perspective that my BFF did after we went to Kenya together! This is a couple of years old, but still amazing. Thanks to her for this awesome piece and allowing me to post it on my blog.

Cheers!

Life As a Medical Student

Hello hello.

Whether you are a premed interested in what your future may look like in medical school or you’ve recently been accepted, finding out what a day in the life of a medical student looks like is often something searched. It is usually difficult to find, and for good reason! Every school, curriculum, and student is different. Making a “day in the life” of student hard to capture.

I am going to be honest here: I was not usually on top of my shit as a student. Despite what the medical school youtubers show you and what the over-achieving instagramers say, most people are not on top of studying or have it together in medical school. It is completely common to be far behind, too tired to finish, or often run out of time in the day to do what you need to do.

Because of this, I spent a lot of time NOT going to class, learning at my own pace, and sleeping. Majority of my classes were not mandatory in person, and they were recorded so we could in essence “re-watch” them later. What that really meant was most students didn’t go to class and just watched them later on their own time.

Year 1:

Year 1 is all about that learning curve. In case you haven’t read a previous post, I went to a school that was known to have a difficult curriculum. They also had block scheduling, and the curriculum taught the “normal” first year and the “abnormal” second year. So that meant first year you would have anatomy, physiology, biochem, immunology, histology, and embryology for each section. The second year was mostly pathology and pharmacology. So you would have GI 1 in first year covering the basics, and GI 2 going over disease and pathology. They would definitely throw in common diseases to be tested on in first year though; they make great test questions. The idea was that you would have the ability to see it twice; as more repetitions = more likely to get into your brain.

Because the school was proud to have a “tough curriculum”, it also meant that you did a lot of self learning. I won’t go too into details, but you would have your lectures/reference books, but a lot of it was not easily put together for you. You did have to hunt to find important information. First year did hand you a bit more, but by the time you got to second year you did a lot more hunting…

It definitely made it frustrating as a student as most of us wanted to spend them time just learning and understanding what we needed to know, but it is what it is.

I wrote a lot of blocks on my classes in first year. But a schedule typically looked like this:

  • Class from 8 am to noon most days of the week. Occasionally we would have lectures in the afternoon, but most of the time we didn’t.
  • Lab usually from 1-4 on 2 or 3 of the days in the week. First year would have PCM, OS, and anatomy labs to fit in during the week depending on the block course you were in. OS and anatomy labs were 2 hours, PCM was only 1 hour.
  • Any additional time spent off was in the lab or studying for your courses.

This meant that you either had to pre-read/review lectures before class and try to learn a chunk of it during class, or do most of your reviewing  later in the evening. I am more of an evening person, so most of my studying occurred at night.

For most labs, you did not have to prep. But for some you did. This obviously took up some of your review time to make sure you were prepared. There were a lot of long nights and most of my weekends were spent trying to catch up simply because of this. As time went on, I stopped going to class to sleep in or try to start studying and just went to campus for labs. For anatomy, you spent most of your time trying to dig and find your structures, but you didn’t learn them well until they were cleaned out and you were able to see them and their relationship in the body. If I would have prepped more before going into lab, I probably would have gotten more out of it.

Our school has something called Mediasite, which is where our recorded lectures would be. They would show up as soon as the in person class was finished. We could speed up or slow down the lectures, so you could get through lectures pretty quickly if you wanted. Other schools I know utilize just voiced over powerpoints, which you cannot fast forward through…

And that was how my first year went. A lot of lectures, doing questions, trying to learn the anatomy, etc. There were some classes that I utilized a lot of additional resources besides my notes, and some where I didn’t need to utilize much. Because I had previously had plenty of exposure to the subjects taught, I knew how to study for them and how to approach them. It was just learning how to accept, study, and understand the large amounts of material in a much smaller amount of time.

Overall I would study an average of 10-12 hours a day first year.

No, I didn’t really work out. 

Yes, I had a lot of anxiety and there was a lot of stress burrito-ing happening and cuddles with my kitty. 

Year 2:

Honestly, more of the same. Except the focus was on pharm and path. I utilized Robbins path and pathoma the most, in order to help me understand and organize the material better. But honestly, you just have to see the material many times in order to understand path.

We didn’t have anatomy second year, so our only labs were OS and PCM. Most of the important skills we actually learned in first year; so a lot of it was review or integrated with some fine tuning. Since we had exposure to how they tested for different scenarios for both courses in first year, it wasn’t as stressful second year.

For our schedule, it was similar:

  • Classes 8-12 (or less depending on the day)
  • and lab/simulations about 2-3 days out of the week. We rotated in smaller groups for more things, so the schedule would look more hectic than it was.

Again, I chose to sleep in during the morning and get a later start to classes/studying than go to class. I simply didn’t learn in class. And if I did go, I could only pay attention for about an hour before I needed to switch. Plus, a lot of our path/pharm lectures were flown through simply because there was so much material and not enough time to teach it.

I’d say I utilized more outside resources consistently for second year, such as Truelearn for questions, or sketchy/pathoma for help with path understanding. So instead of multiple books, youtube, paid resources, etc, I just used the same 1-3 sources. First Aid can also be utilized as well to help organize your thoughts for path.

Then towards the end of the year you start gearing up for boards and dedicated. See my other posts for that information.

Overall, I would study maybe 6-8 hours a day consistently for second year. Partly because I was burned out, and partly because I would avoid my duties due to stress. It is what it is.

No, I still didn’t work out. I did hang out with friends more though. We would call it “study group” but only about 1/2 the time was spent studying… 

Year 3:

Well, I’m just starting so I don’t have much to offer yet!

But my site is doing what they call the “2+2” method. It is where we are in clinic for 2 weeks and then off for 2 weeks. But when we are on, we are on. In my first rotation this meant I was on straight for 14 days. Anything that was on call that my provider called me for meant I needed to be there. It was a bit exhausting by the end. I didn’t really get a “day off” until my 14 days were done. 

I know in the future, my schedule could be any combination of weeks on/off. It just so happened that my first rotation was one off, two on, one off. Because of this program, we have more work to do than our classmates. We all have some online work to do (and by we I mean my class as a whole), but my site has more additional projects that count towards our grade. This includes case presentations, powerpoints, standardized patients, and virtual reality. 

On my weeks off, it would usually consist of doing the work assigned for a grade, flash cards, and practice questions. 

For my first rotation, my scheduled looked like this:

  • 6am Rounding: As a student I would go before clinic started. I would usually run into my attending as I was finishing up so I could present. Then we would go see the patients from there. If I finished beforehand, I would look up the first few patients in clinic for the day so I had their information handy if I was sent in to see them.
  • Clinic from 7am-4pm (which always ran late).
  • I was on call the whole time, so if anything next door on the floor was called in, I would leave clinic to go be with the attending that was dealing with that. Sometimes it was the attending I was with, sometimes it wasn’t. Weirdly, I was usually with the attending in clinic that was on call that day. So it worked out in my favor. So if a baby was about to be born, we would leave clinic and go deliver and come back.
  • Some days we would have scheduled surgeries mid-day. So usually over lunch?
  • After clinic, we would visit patients on the floor. Usually started sometime after 5 pm. We would check in with any mom’s that needed to be delivered, or anything that was admitted while we were in clinic.
  • I would usually leave anywhere around 6-7 pm. 
  • On the weekends I would be there from 6/7am-7pm. I think there was one night where a case went haywire and we were there pretty late. 
  • This was a mix of inpatient and outpatient.

And that was mostly how my first rotation went. I only had enough time to shower, make food, and eat before passing out during the 2 weeks I was on. And since it was my first rotation, I hadn’t learned how to work in studying yet and hadn’t gotten used to the physical exhaustion yet. Hopefully my next rotation I will be better with this!

All I know is my next rotation is peds. I’m off the first two weeks and on the last two. I believe this rotation is just inpatient, so I’m expecting to be doing regularly scheduled 12 hour hospital shifts, but will let you know!

Cheers!