Transitioning into Clinical Science

I spoke with a friend of mine who just graduated from WSCC this month about the transition from basic sciences to clinical science yesterday and felt compelled to write a blog post about the conversation.

I found the conversation a bit depressing but quite informational as to how to tackle the transition. He told me the information to prepare for the OSCE's as well as the later, more difficult boards is hard to come by even though you go through all the classwork. Supposedly the organization of the coursework and information to make the transition could be better and the basic sciences is above and beyond the clinical sciences in many ways.

One way the clinical sciences is lacking is clarity. Meaning, we are expected to retain all the information learned in pathology and gross anatomy as well as physiology and PDx as if we are walking medical dictionary's. The notes get more confusing and less organized that what they currently are, supposedly. Apparently the expectation as far as performance increases significantly from here on out and the days of logging time in the classroom are over. Its time to become proficient chiropractors and I guess that transition is insanely hard at WSCC.

The professors get harsher and more demanding too. Pathology was a walk in the park compared to what will be expected from us in the very near future.

My friend advised that I buy the orthopedic physical assessment book that is displayed in the bookstore as well as a "learning radiology" book that he found useful. I plan on doing just that so the information has some order to it and is readily available if I need to reference it.

I think any clinical education comes with the hard transition from classroom stasis to application. Extrapolating the vast amount information lodged in our craniums is going to ridiculously hard. We will have to follow the "rules" as to what WSCC expects from us as to how to come to a diagnosis based on a very strict, set criteria. We'll need to show proficiency in how to perform physical exams, our bedside manner with patients, our knowledge of disease, the treatment of disease and of course the prevention of it. All of the information we've learned in neuroanatomy, neurophysiology, gross anatomy, even physiology will be connected in the next year so we are competent interns beginning in 2011 (for some of us).

This transition seems quite daunting to me. I have been very good at preparing for exams that consist of multiple choice and true/false questions but not short answer/essay questions. The answer is more or less always there so retaining the information has been merely based on word recognition and minimal at best. I looked at the clinical proficiency exam we must take at the end of next year, in December and the difference between it and the tests we've had thus far is that every single question is essay style or short answer. And it consists of MANY questions. I find this stressful and hope I can get through the rigor of such an experience. Currently, I would fail it miserably and can only imagine how stressful the experience will be during those weeks.

For now I will do some preparation for part one boards and do my best to really master the next quarter's material early on. I think the only way to really get proficient is to start early and use other's experiences, like my friend's, to guide the way. No matter what, this next year will dominate our time and make us grumpy at times. There is no way around it. There will be some who continue to wait until the last minute to study, I will likely be included in this population to some extent and we'll experience stress unlike we have to this point.

There is one week left until it starts. I am going to enjoy this time off because I know once we start it's going to get crazy.

The Halfway Point

By mid-quarter in February I will be officially halfway through chiropractic school. It is exciting and daunting to know I have so much more time to spend at WSCC before I graduate. The hard exams, the brutal schedules and lack of sleep that will be endured does not seem fun. In the long run I know this path is the right one.

Ending the basic sciences in any medical program is a huge breakthrough. No more genetics, biochemistry, or any other class that doesn't apply to clinical practice. Now it is time to transition to the clinic and march forward toward the reason we came here.

This quarter started a bit rocky with our pathology teacher being publicly scorned in front of our class and with me catching swine flu (I think, anyway). It ended similarly with everyone pissed at the pathology instructor but thankfully, I was flu free. The class was taught a lesson as a whole this quarter due to a select few who have treated the instructors and their classmates unprofessionally since the beginning of school. Unfortunately, the students not involved with their antics were punished too. Our pathology instructor did the punishing by slowly ramping up the intensity in the class. He gave pop quizzes over an enormous amount of material and in the end he gave us a final exam consisting of diagnosing conditions versus testing us on what he went over in the class. In a way he did test us over the material but it was written to intimidate us and confuse us rather than test our knowledge of the individual pathologies.

He got under my skin pretty bad because I felt I was prepared to be tested over his notes. After 50+ case studies to diagnose, I was shaken for the rest of the exam. I ended up getting a 71% on it. After he curved the exams I got 71 out of 78 correct. I suppose that is fair being that the majority I missed were the case studies. I will look at my exam when I get back and talk with him about why he did this to us. My hunch is that he has never been treated so disrespectfully by graduate students. In my mind, those who have been unprofessional needed to be shown this path shouldn't be taken for granted. We should be respectful to each other and our instructors. If something is not fair discuss it diplomatically rather than disrespectfully.

On that note, I am happy things went the way they did. Initially, I was upset and wanted revenge but after thinking it through, I think what happened needed to happen. After the exam people were crying and carrying on about how unfair it was. In a way, I am glad we were pushed to this limit. It seems to me that there are a lot of people who need to be taken down a notch at our school. To be humbled is a good thing every once and while. I think the visceral reaction to the exam was because we work so very hard for our grades and when there is a possibility of having to retake a class like pathology, it makes you wonder if this path could get any harder.

Now that we are halfway, I am hoping the lessons learned (or not learned) from the first half of the program make the school less unbearable to go to. Socially I can see our class bonding more and relying on each other to get through. We'll be forced to change and adapt in new ways that may make us all double think why we chose such a rigorous career. In the end, we'll be there with a new set of tools to help a lot of people and walk across that stage to receive a doctorate degree.

I hope everyone has a nice break.

Weeks and Weeks of Exams...

We have been inundated with exams the past 4 to 5 weeks having 2 to 3 per week. The last exam was finished today in microbiology of which I surprised myself with. I committed the material to memory without going to one single lecture!

Granted it took some effort but not as much effort as it takes to drag myself into school at the crack of dawn. I think approaching school this way will be beneficial for my psyche and based off my attitude when being diligent in planting my butt in a lecture hall, I think I prefer the former idea.

The exams are done which matters most. A sigh of relief can be had until the 14th which is when finals are, until then I intend on getting ahead this weekend and next week, reviewing early rather than the night before the final.

There isn't much more to share right now being I am so exhausted. After finals I will update with a nice synopsis of the quarter and venture forward into the next phase, the start of our clinical education.

All for now