The Match Results Are In

Sleeping the night before was not as hard as I expected it to be, but the day of the match results (February 13th) I woke up early. Before I even made it out of bed, the email shown here greeted me with very good news! In just a few months, I will be joining Arrowhead Regional Medical Center's newest team of emergency medicine residents!

Residency Here I Come!

Like many of my colleagues, I had no idea that the match results would be emailed so early in the day. Social networks were abuzz from classmates and peers around the country celebrating and spreading the news. For some it was a time of joy and for others one of disappointment that they either did not get the program they wanted or none at all. It was the major topic of discussion; sometimes surprising and often times expected. Fortunately, in the osteopathic match we do not have to wait a number of days before knowing the results, they are given in the same email. For those attending allopathic schools, they learn that they have matched and wait a few more days before learning where to and in what specialty.

I feel so very fortunate to have matched with a strong institution replete with diversity and opportunity. With the news, I can start looking for housing arrangements and vacation opportunities before everything begins. It's a relief I thought would never come when I was starting out more than three years ago. Now the looming realization of being responsible for someone's health is setting in. For now, I am just going to enjoy knowing that things are going to work out just fine.

Question of the Week

Where did you match and into what specialty?

Answer & Explanation

Good News Test Results

Despite the normal challenges of being on rotation, this week had at least one positive outcome. Like the good ol' days when report cards made their way to the refrigerator door, so did the test results of my most recent exam. It was partly for nostalgic effect and partly because this was by far the most expensive exam I had ever taken. Tabulated expenses were a total of $1,500!

COMLEX Level 2 PE

Being that this test was among the medical school series of board exams, it comes as no surprise that the results were a relief. The examination itself was not horrific, but the cost was ghastly. I was more worried about having to fork out another payment than studying all over again should I have to retake it. I now feel one step closer to graduation and have only one more exam remaining to make it out of medical school as a doctor. That is a really good feeling that is going to be much better when the next board examination is behind me.

Preparing for the exam was not as difficult as I expected. Classmates and I would get together a couple times each week for a month and perform timed practice scenarios from the book First Aid for the USMLE Step 2 CS. Taking turns as patient and doctor, we slowly got into a rhythm that would set the pace for exam day. The video orientation on the NBOME website provided test site details that helped to plan resources and expectations on test day. The rest was a matter of showing up for the exam on time and keeping calm. Faster than I expected, the day was over and weeks later I have my passing grade. Two board exams down, one more to go.

Question of the Week

A 19 year old male comes to your clinic complaining of a sore throat with no cough for the last three days. Vital signs are normal except an elevated temperature. On exam you note the patient has "kissing tonsils" with exudate and cervical lymphadenopathy. If this patient did not receive treatment at this time, he would be at risk for which of the following conditions?

A. Subacute Sclerosing Panencephalitis
B. Wegner's Granulomatosis
C. Membranoproliferative Glomerulonephritis
D. Rheumatic Heart Disease
E. Chédiak–Higashi Syndrome

Answer & Explanation

Prepared for Chaos

As a young Boy Scout, I always loved reading through the handbook and learning how to MacGyver objects on hand into something useful. It was continuous testing of the Boy Scout motto "be prepared." In emergency medicine the challenge is similar; always being prepared for the worst case scenario. [Pictured: Make-shift hospital outside St. John's Regional Medical Center in Joplin, MO. Image provided by Mercy Health]

Ready at a Moment's Notice

In recent headlines, tornadoes have shown their gruesome force by leveling towns and causing mass chaos. The incident in Joplin, Missouri was no different and Dr. Kevin Kikta shared his experience of the night the tornado destroyed his hospital in 45 Seconds. This is a prime example of being ready for the moment when everything is wrong. He managed the care of patients with the limited tools on hand as he moved from one to the next. He didn't need functional rooms, a full set of staff, or the best equipment. He knew what needed to be done and found a way to make it happen. He was prepared.

I suppose this is the "what if" game so many emergency medical professionals play when they have time to think. "What would I do if...?" we think to ourselves and play out a scenario that one would never expect to happen. After playing the game enough times, you start to realize how your response to a particular situation changes to maximize your performance. Should the situation play out, you might just be one step ahead rather than caught up in the element of surprise. Whether the Boy Scout manual was premature training or the "what if" game preparatory, I hope that in those unsuspecting situations I will be prepared to act accordingly.

Question of the Week

Shortly after having a subclavian venous catheter inserted, a patient is noted to be acutely short of breath with rapid and heavy breathing. He is not yet in respiratory distress. A chest x-ray reveals a pneumothorax. Management should consist of

A. removal of the central line.
B. insertion of a new central line on the other side.
C. insertion of an angiocath in the third intercostal space on the side of the central line.
D. insertion of a chest tube on the side of the central line.
E. insertion of a chest tube on the side opposite the central line.


Answer & Explanation

Controversial Medicine

Microscopic science is hard to keep up with and the debate of ethical standards in relation to stem cells is still out for debate. On which side of the fence do you stand when it comes to organically derived medical procedures?

Stem Cells

I was recently asked to comment on a case between the FDA and two physicians vying for a new stem cell procedure. The orthopedists posit that they are using a procedure that implements host stem cells to repair orthopedic conditions. Their opponent, the FDA, argues that when these cells are returned to the patient's body they are considered a drug and not part of the patient's body. If the cells are to be classified as therapeutic drugs, a different set of guidelines is to be followed and FDA approval must be obtained for patient safety.

The physicians claim that the procedure is safe and has no place in the courts as the cells are simply being returned to their original host, but they are willing to fight the FDA to prove their point. Dr's Centeno and Schultz issued this press release about Regenerative and the FDA. If you knew there was a procedure that was safe and used your body to bring optimal recovery, would you be willing to take part even if it was new medical therapy? The thought of not enduring surgery to get results may actually be very comforting to some. To learn more about how patients can still avoid the need for invasive orthopedic surgery, see Regenexx SD link.

We commonly look to the FDA to recommend and ensure product safety and tend to trust their judgment both as patients and providers. In this particular case, however, their control might be infringing upon the rights patients have concerning their own body parts. Is this patient safety or medicinal dictatorship?


Question of the Week

A physician-scientist is conducting an experiment in which she tries to stimulate growth of cartilage in vitro. She wishes to use a substance to stimulate histogenesis. Which substance would be best suited to her purposes based on its stimulation of cartilage growth in vivo?

A. Cortisone
B. Estrogen
C. Thyroxine
D. Vitamin A
E. Vitamin D

Answer & Explanation

Healthcare Reform

Political propaganda just keeps rearing its face in lieu of the healthcare debate. Making sense of it all is an entirely different story and I am no where near understanding.

Healthcare Debate

With the new president and political party, we are soon to be introduced to a new form of healthcare. As medical students we may not yet be intimately involved in the business aspects yet, but we certainly will be in the future. Medicine as we know it today will change to adapt to the new policies decided in Washington.

In March, the largest gathering of osteopathic students and professionals held a conference in Washington D.C. to share their voice with politicians concerning healthcare reform. Considering the task before them, politicians may take a while before coming to a consensus, but the August deadline remains.

It is exciting to imagine how things will change by the time I and my colleagues graduate. Nevertheless, the majority of physicians are not content with the way things are moving. Understandably, the idea of doctors doing more and getting paid less is not an appealing alternative to their current standing. Perhaps if doctors were to be sponsored like professional athletes, there would be no need to worry.