Tag: Kansas City university of medicine and biosciences

Gastrointestinal Block

Hello MedHatters!

I thought I would try something different with this post this time around. If you are interested in my thoughts as I progress through the course, this will be in the first half. The second half will be detailing more of the course like the rest of my block posts have been.

Pre-Midterm Thoughts…

Hmm… This block.

This was has been a swift kick in the butt that said less “Welcome Back” and more “Are you off your ass yet?” type of course. But that’s okay. I really wasn’t sure why I was expecting rainbows and rose petals and all that jazz when returning to medical school from winter break.

I feel like I’m staying on top of things, but who knows!

I’ve definitely had a rollercoaster of emotions again (like I do with every block really…) while going through this course. Part of it was getting back into the swing of things, and part of it was anatomy lab was another balancing act to add onto my plate. The last lab component that we had wasn’t all that difficult in cardiopulm. In fact, it was pretty straight forward as there weren’t a shit ton of things to remember and dissect out.

This one is a little closer to how our musculoskeletal lab was. I think we have like 6 pages of structures to know? I’ll have to take a closer look before I take the practical as hopefully there are some repeat structures.

Anyways; I’m a bit cranky this morning. Probably shouldn’t be typing this up right meow. Will check back in on another day for more thoughts.

Giphy.com
Post- Midterm thoughts, pre-final thoughts:

So. It’s currently MLK weekend and I have an extra day for studying. I have one more full week until my final happens and I have to really kick my booty into gear.

Right now it’s Sunday, so today and tomorrow I can try to fit some studies in. I have my cat ear headband on; I need to kick some butt today!

I have my coffee from my current fav coffee shop, have my smoothie, and am all set up. Currently, I’m set up in our mock patient rooms. It’s a nice personal space that has a movable table, chairs, a semi-comfy patient bed that I can lounge on, and a nice big window! Anybody else love having a window to look out of while studying? It’s also not the “typical” study room, so I don’t have to sign it out.

AKA I can be here all day without having to move.

I’m glad I currently feel positive, but that may fade fast. I was really annoyed at myself for basically doing nothing the past 2 days. I went to class on Friday, but unfortunately for me I wasn’t in the mood to actually pay attention. So even though I was there physically there, I wasn’t mentally present. The rest of my Friday I hung out with E, doing coupl-ey things. Like date night!

And Saturday. oof. Well, I was having a day yesterday. I was angry that I wasn’t motivated enough to do anything even though I had a shit ton to do. I was mad that all I wanted to do was lie down in bed and play on my phone and cuddle my cat. And every time I attempted to look at something, I would just get distracted and get more angry at myself for being distracted!

Yesterday was a mood for sure. Hopefully today won’t be one. Will check back later.

[Later]:

It is freaking freezing in this room. How do I change this temperature? I’m gunna turn into a snowman. And not a cute one.

[Mucho Later]:

Welp I definitely didn’t get through nearly as much as I wanted.

Merp.

At least I got through two anatomy lectures. I half-assed my way through part of a histology lecture and did some physiology reading. But really Joyce, I wanted to do more. Will try again tomorrow!

Weekend before the final exam:

Ahh. It’s hitting me now. The panic is setting in. The performance anxiety. The ‘do I know enough’ anxiety. The ‘will I actually get a higher grade than the average so I look smarter than everyone’ anxiety. Actually scratch that. All the anxieties are setting in right about now. 

I can feel my stress level about to bubble over. I’m not feeling super motivated to do much; but at the same time feel like I’m drowning in material that I still need to learn/master. I feel like I have no time given that the anatomy lab component of this and in general, the way our schedule has been this past week hasn’t left a ton of time to review or learn material. I feel like even though I’ve gone over a lecture 2+ times, I’m not retaining any of it.

Me trying to get at that material. (Giphy.com)

Joyce has gotten on the struggle-bus to struggle-town and she’s not sure when she is getting off. 

It’s definitely interesting when medical students and pre-med students post on the internet all of the amazing things that they are doing/experiencing and all the positives. Positive is good. But positive is only a fraction of what actually happens in medical school. And since I’m a realist, Imma show you the real shit. Like now, when things aren’t rainbows. Because honestly feeling inadequate and stressed and overwhelmed and not smart is a really large chunk of what you go through in medical school.

giphy.com

I’m also writing this right now because I’m in a really down mood, and letting this out is weirdly therapeutic for me.

[The next day]:

In case anyone is curious how my day was going, I put my scrub top on backwards.

No. Not inside out.

Backwards.

With the front “v” and pockets on my back. Maybe I should just go to bed early tonight and cut my losses.

Post Final exam:

Well fuck.

Ugh.

Maybe one day I will eventually walk away from taking a test and be semi okay with my score. But I guess this was another block where I was not. I’m getting really annoyed with myself and how different topics are being taught compared to how they are asked on the exam. I can’t really seem to grasp it how I want.

Which is weird. Because I was acing majority of the practice questions I was doing…

AND I had a super false sense of confidence and being positive while taking the test. Totes thought during the final exam that I was KILLING IT.

And then my score came back. 

The worse part is I’m pretty sure most people did okay on this test or fairly well. I won’t know for sure until our scores are up and I can see the average, but I’m pretty sure I’m below average on this one.  Which means I won’t get as great of a boost from the curve.

Whatever. (I’m not salty at all…)

Maybe next block will be my bitch. But really, it seems like every block is not my bitch. You know, while scribing I would cross off specialities that I knew I didn’t want to do. Like ER. Or family medicine. Or Ortho.

Why? Because I mostly didn’t like the environment. Or the content wasn’t as interesting to me. Or I was bored fairly easily or was jaded too fast while working in that speciality.

It also could have been the type of people but ya know, that is very variant on where you go.

So I thought to myself, “Joyce, when you get to medical school you will SURELY find topics that interest you! We will find other possible specialities to consider besides just neonatology!”. However, almost every block so far has also caused me to cross off topics that aren’t interesting to me.

I’m really really hoping that it’s just the way our curriculum is. Maybe second year when its more pathology I’ll be interested. Or maybe I won’t get a good feel until rotations.

Either way, I’m feeling very stuck and unhappy with my performances.

Merp.

Oh well. Guess I’m gunna go clean my apartment which I’ve been neglecting to do for a few weeks.

Block Breakdown:

Okay. There were a lot of different classes this block around. Different disciplines involved included:

  • Biochemistry– we had one biochem lecture this whole section. It went along with the physio lectures we were having. In pasts sections we had pretty easy biochem questions: they were obvious. This time not so much. So make sure you look at this.
  • Genetics– There is like one genetics lecture that we had. Again, it coincided with some of our physio lectures. But just like biochem, they were not as obvious as I was expecting.
  • Immunology– We had one lecture. It is different from the information that we learned in COB as it was more medically related and just focused on the gut. But in general, having Dr. Shynra previously in COB is always more helpful than those who did not have him.
  • Pharmacology- I really didn’t understand the need for this one. This is the same content (almost identical really) to the lecture and DSA’s we were given for cardiopulmonary. I also think we got a similar one in MSK. HOWEVER, don’t punt this bitch. It was like 9 some questions on my exam and I think I got all of them wrong…
  • Histology– There were a few histology lectures this time around. Majority of it we were tested on during the midterm. Less so on the final. BUT, we had histo show up on our lab practical.
  • Embryology- we only had one embryo lecture this whole section. We were tested on it on our midterm. However, there were embryo questions (that weren’t necessarily just from this block) that popped up on our anatomy lab practical. The practical wasn’t until the day of the final exam.
  • Physiology– So. Much. Physio. You will be doing a lot of physio in this course. If physio is for you; great. If not for you; pull up your bootstraps baby because it’s about to get wild.
  • Anatomy– There is also a fair amount of anatomy in this block as well. But honestly, there was definitely more physio to be concerned about.

Our lab practical also had not just anatomy on it, but histology and embryology on it as well (which is a mostly new testing breakdown for lab). They also upped the amount of stations from 50 to 60 questions in the lab practical (so more rest stops were taken away), AND everything for the practical itself was cumulative between the knowledge we learned in lecture for both midterm and the final.

But the lecture exams were not cumulative…

Midterm Breakdown:

  • 23 Anatomy
  • 7 Embryo
  • 9 Histology
  • 9 Immuno
  • 14 Physio

62 Total

Final Breakdown:

  • 26 Anatomy
  • 5 Biochemistry
  • 5 Genetics
  • 5 Clinical Medicine
  • 5 Histology
  • 9 Pharmacology
  • 37 Physiology

92 Total.

How I studied/What I found Helpful:

Well for lab, things need to be dissected out (just like what I’ve said previously) in order to actually learn them. Physically dissecting them out didn’t help me learn it. So going in like the half of week before once everything was dissected out (or mostly) was more helpful to me than actual lab time. With that being said, most of our GI sections were not embalmed well and so things were more difficult to find than say in MSK. And, that also means you do need to spend time outside of lab working on it just to make sure you can see the structures.

Remember, anatomy fellows will tag poorly if you don’t dissect out your bodies enough (or at least in our year they have).

For class, specifically physiology I read A LOT. A lot a lot. I know it helped somewhat since I didn’t miss a chunk of the physio questions, but you still need to make sure you go over that info several times. Do those practice questions. Unfortunately for me, I was doing well on the practice questions (in most disciplines) for the final but the questions on the test were not as clear/harder.

For anatomy, you just have to draw shit out. I watched both lectures (on KC and Joplin’s) campus for anatomy. Draw, draw, draw.

For genetics, Dr. Staudinger’s blue boxes are what you need to know. For biochemistry, Dr. Zaidi highlights things in red. You don’t really need to read outside of their lectures as they provide majority of the content you need in their powerpoint slides.

For Dr. Kruse’s lecture (pharm), IDK. IDK what to tell you man. I didn’t understand this shit and not sure I will ever just on the level they want us to. Pretty sure next year’s pharm is not structured the same way. But, with that being said, you actually have to spend a decent amount of time with this material too. It’s hard stuff and not always logically easy to get.

Sites that I found helpful:

For physio, this KUMC.edu site is a list of terms and some processes. It’s not pretty but it definitely helped me the first time around for the midterm.

For biochem, my professor gave us links to Handwritten tutorials which are a few minutes long and Osmosis. They were pretty concise and easy to follow.

For Histo, I’ve used Blue Histology , Histology Guide, and Chapman’s 3 minute Histo youtube videos. Chapman and Blue Histology were also recommended by my professor, but so far it looks like Chapman’s videos are mostly GI related. Not sure they would work well in other sections.

Teach me anatomy is a favorite of some of my classmates. And no, you don’t really need to login to get the information. I was able to a access what I needed without that. There are plenty of websites though for anatomy and anatomy apps. If you’ve found one that works previously for you, stick with it!

Lastly, There were some classmates who used online notecards from Brainscape or Anki that were made from previous years. Couldn’t get my hands on them. BUT, make friends with previous years, they can usually give you pre-made resources that will help cut down some time for you.

And uh yea, that’s it. I would apologize again for the long post but I think this is becoming the norm. I bet I could blabber on long enough to write a book at this point! See ya’ll next week.

What is Osteopathy?

Hello Medhatters!

For those of you who did not know, I am currently (as of 2018) an OMS-1 student at Kansas City University. As an osteopathic medical student, this means I am not only learning all about medicine in the traditional sense, but also learning how to manipulate the body through osteopathic treatment and manipulation (called OMT or OMM) to learn to treat disorders of the body.

If you are looking into medical school and are undecided if you should go the MD or DO route, hopefully this helps clear things up a bit for you. If you are just curious or just starting out your research on medical school and medicine, I hope this sheds some light for you as well!

What is Osteopathy?

Osteopathy is the philosophy of knowing the structure and function of the body and being able to use this knowledge to aid in the health and healing of the body. This practice looks at the host, (or patient) as a whole, instead of individually looking at just the problem area. In combination of seeing the patient as a whole + treating the disease/illness = overall improvement in health. By using our hands to feel and use OMM, we can help accomplish this! And this is generally how osteopathy operates.

How is this used in practice?

According to AACOM.org, “Osteopathic medicine provides all of the benefits of modern medicine including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury. It also offers the added benefit of hands-on diagnosis and treatment through a system of treatment known as osteopathic manipulative medicine. Osteopathic medicine emphasizes helping each person achieve a high level of wellness by focusing on health promotion and disease prevention.”

You can also check out the link above for more information on the American Association of Collages of Osteopathic Medicine's website.

So, we still learn how to do surgery (in residency if that’s what you choose to go into), prescribe medications, and learn all about disease processes just like MD students do, but we add learning how to do OMM. OMM is used to treat things such as tight muscles, to treat a fancy term described as somatic dysfunction (which is anything that is unequal or off from the normal for the patient that can be treated by OMM more-or-less), poor circulation of lymph or blood flow, etc. In my first semester, most of what we have learned so far is finding if one side is unequal to another, or finding a very tight muscle and learning to fix it or cause it to relax. (This has been great for my tight neck and back!)

Now, OMM doesn’t treat everything. There are many types of techniques that have both general and very specific contraindications (or makes that treatment inadvisable to performing it on that patient). There are also many different types of treatments that we learn. So if one doesn’t work, there could be many others that may work.

However, if none of the options are recommended to be performed on a patient, or they aren’t working/the patient cannot tolerate them well or isn’t understanding the directions well, we need to look into the more “traditional” method. In this scenario, an osteopathic physician would treat the disease itself (so your typical medical measures such as medication, surgery, etc) as the patient would be unable to handle OMM without potentially causing more of an issue. But as a whole, if we can integrate OMM in combination with medically treating the issue, the patient should overall have improved health.

Honestly, I think this has a lot of appeal. Think of how many patients who do not want to undergo surgery, take pain medications, or muscle relaxants when they can come get a few second to a few minute treatment on their problem area(s). Its much less of a cost, much less invasive, and has immediate effects if it is indicated and safe to do OMM.

As a side note; just because an osteopathic physician is trained in a more wholistic fashion, doesn't mean many of us are also well versed or trained in holistic medicine. Some providers will know a lot about supplements and alternatives in that sense. But we do not get additional teaching on this. This has to be a side interest for any physician to learn. 

Some physicians may also learn things such as acupuncture or massage therapy to help assist with OMM. But again, not every provider will undertake this!

4 tenants of Osteopathic Medicine

There are 4 tenants of osteopathic medicine that we abide by. They are brought up many times (at least during our first year) and are listed as follows:

  • The person is a unit of body, mind, & spirit
  • The body is capable of self-regulation, self-healing, and health maintenance (Meaning may leave it to fix itself. However if having a fracture & displaced arm, interventional treatment is needed to help itself heal)
  • Structure and function are reciprocally interrelated
  • Rational treatment is based upon understanding & implementing the other 3 tenants

History of Osteopathy

Osteopathic medicine all started with this guy ——>

A.T. Still.

At my school (and I’m sure at many other D.O. schools) we have to learn about what happens leading up to this main point, but basically after the Civil War (in which A.T. Still was a general in the battle of Westport; which is now a bar scene/district in Kansas City), he went back to his farm to live a “normal” life. 10 years after the war, in 1874, he “flung his banner into the breeze” (don’t ask me what that means because I still have no idea) which basically meant he decided to pursue his idea of osteopathy. At the time that he was a farmer, he was also the town’s physician and a Methodist church pastor.

When he spread the word and his idea about osteopathy, he was formally removed from the Methodist church and basically outed from his town. This is all still occurring in 1874.

Additionally in 1874 the first osteopathic technique was recorded. By 1875 A.T. Still officially moved his family to Kirksville, MO and he continued to work as a traveling physician in rural MO (since ya know, he was run out of his town and he had to keep making money).

Side note; Kirksville, MO ends up being where A.T. Still University (a DO school, obvi) will be in the future.

By 1885, Still coins the term “osteopathy”. Which doesn’t seem like a big step now but we use it daily in DO school.

In 1886 he becomes busy enough to stay in Kirksville and be the town’s physician.

It took until 1892 to open his first school, coined American School of Osteopathy (which will later become A.T. Still University). By 1900 it becomes the largest school of the healing arts.

Prior to A.T. Still passing away in 1917 he ends up publishing several books based on his research, his techniques, and his autobiographies.

How DO’s treat: the approach

Now, I don’t have a ton of practice in this yet and we haven’t really learned to integrate this into our PCM courses, SP encounters, or future patients. But so far in my first semester, we learn how to do an isolated exam and then to treat what we’ve learned so far (when in our osteopathic labs only).

From how we’ve been taught so far, it’s by far easiest to ask if there are problem areas for us to look at (because let’s be real, you don’t normally do a full body exam to find something. The patient tells you what’s bothering them!). Then we assess if its symmetric/even to the other side or not, tense, or more rotated/prefers one side.

Usually if you look hard enough though you can find something to treat. Or you don’t have to look hard at all. I mean, there is that too lol.

When assessing we look for TART. Which stands for tissue texture changes, asymmetry, range or motion, and tenderness. If there is any one of these, or more than 1 of these, it is worth looking into more to decide to treat. Then we pick a technique and “try” to fix the problem area with the limited number of treatment types we’ve been taught. I say “try” because 1) I’m a first year and I’m still trying to figure out what I’m feeling and 2) it may work for many patients but not be the best technique for that particular patient & their problem. Or 3) they need a combination of a couple of different types of treatments.

So far I have learned how to do soft tissue techniques (similar to some types of massage), lymph flow improvement, muscle energy, articulations, and I’m currently learning counterstrain! 

We will eventually learn how to pop (called HVLA), BUT, that is not everyone’s cup of tea. It certainly isn’t mine. But popping isn’t the only technique we learn or that DO’s use. In fact, I would say counterstrain and muscle energy would be more widely used to treat.

From my understanding, by the time we have boards we have to do a full “SP” encounter (for more information on my PCM course check out my What is the PCM Course at KCU post) and do an osteopathic examination/TART screening, and a treatment for that area.

Since we aren’t there yet in our first semester, we don’t have to worry about trying to do an osteopathic exam or a treatment for the person’s issue. I’m sure we will start to learn how to do that by the end of our first year or the beginning of our second year.

Again, we integrate OMM like we would with any other treatment. So, if you have an elbow that bothers you and a physician recommends rest, ice, ibuprofen, and reducing activity, a D.O. physician may also do an OMM treatment to help the body move healing along at the elbow joint as well.

Lastly, if you go into a specialty where OMM doesn’t really integrate well, or you choose not to use OMM, that is okay too!

As always, let me know what you liked, didn’t like, or what you would like to see next in the comments below!