the last hurdle

With only 5 months left before I become a veterinarian in title, and with boards and Grand Rounds behind me, there is but one thing left to do: find a job.

Last year at this time I was kind of happy that I still had a year before the job-search began, given the crappy economy and all. And sadly…I’m not super excited about the prospects now, either. The economy might be better (?), but in the area that I’m looking, jobs do not abound.

All the same, I have a list of good and recommended practices in the area (in a shiny new database, naturally) and today I focused and made cover letters for each; even if they aren’t hiring, maybe they’ll see me and won’t be able to resist? Ha. Perhaps not. But I am hoping that something good will come of it. Some good…like a job.  I’m also sending resumes to a few practices that don’t look that exciting but are actually hiring, just so that I might get some interviewing practice in.

When I graduated from college, I had my choice of jobs, salaries, benefits, schedules and locations. Ahhh, 1999. I miss you.

cardiology…wow!

Cardiology is a one-week elective here; you could  try to take two consecutive weeks but to do so would be a stroke of great scheduling luck because of the spotty availability of the cardiologist. It’s rumored to be a good week, you learn a lot, usually 8-5, etc. “It’s totally chill,” gushed one of my good friends.  And while the first part was true – at least I was out by 6 each day, and in at 7am only once, and I certainly learned a lot; it was anything but chill. In one week I had only three cases to call my very own, and they treated me to some of the most mentally and emotionally exhausting work I’ve done so far.

One of the cases was an outlier: a healthy older dog with a heart murmur. An echocardiogram revealed moderate A-V valve disease, and our recommendation is a recheck in 9-12 months. That’s how I thought the appointments would go.

The others were far more complex – multiple system involvement, and both reaching very sad conclusions. They are the kinds of cases that I wish I could describe here, but to do so and maintain confidentiality would be far too difficult for my kind of exhausted mind. Despite the sadness, they were great learning experiences, both from the medical perspective and also from the grief-management perspective.

I’m taking another week in February, and am curious to see what it brings. In the meantime: TGIF! And I have a nice weekend planned: some work on resumes and homework tomorrow morning, but then a trip to Cirque du Soleil tomorrow night and Christmas tree chopping and decorating Sunday!

best client yet

She came in, 15 minutes late, with her sick young pet, wearing a white coat. And, I kid you not, a stethoscope. And announced immediately and importantly:  ”I’m a med student, so I know alllll about this stuff! That’s why I’m so late you see, I had to see patients*”.  (a 3rd year medical student, upon further questioning). And then curiously proceeded to smile condescendingly when I explained that I was a 4th year veterinary student who would be taking the history and performing a physical before the doctor came in. Like somehow my patients (her dog!) were so much less important than hers.

Her history questionnaire was full to the brim of acronyms and medical lingo, just in case we dare forget her stature.

She proceeded to instruct me on the best method to restrain a dog (because, you know, restraining animals isn’t something I do repeatedly, every single day). She told us to place the dog on his left side because it’s MUCH easier to hear the murmur that way (because, you know, dogs are little furry humans and their hearts are also left of midline). And when it came to a sore paw, she had localized the lesion to a tiny pedal muscle that dogs don’t actually have – and if they did, it wouldn’t make sense to try to localize anything that precisely anyway.

When it all came down to it, she actually was nice enough; just so cluelessly full of herself that she was automatically condescending, whether or not that was her actual intent. I couldn’t help be put off almost immediately.  And, truth be told, alternatively giggle and seethe about her for the rest of the day.

* I could almost forgive this comment because perhaps she was trying to tell us not to dumb anything down; but still…ICK.

another rotation ends, another vacation begins

My second primary care rotation is over, and I enjoyed it just as much as I did the first time I took it. It made me happy, erased any negativity that might have built up after working with cows and radiographs, and totally reminded me why I want to be a vet. We were busy but not overwhelmed, got to work with four different doctors (I so appreciate variety when it comes to role models).  It was a great two weeks.

And now, I am on vacation again. It’s just for a week – next Monday I’ll start a one-week Cardiology rotation. I’m flying home tomorrow and it feels completely surreal. I don’t feel at all on vacation – even now, just a few hours in, I’m stumbling around trying to figure out what I should be doing.

And of course, what I should be doing is cleaning and packing. Going to the gym and reading one of the books I picked up from the library. Texting my friends who are taking the boards this week my good luck wishes. Making Christmas lists and unpacking decorations. Just life, in general. After three years as a veterinary student who has spent this time cramming for exams, you can understand why “life” is feeling a bit foreign.

NAVLE redux

First, to answer a common question: the site where you can get a  practice board question e-mailed to you daily is: http://www.zukureview.com. This site also has a lot of good review materials, and you can buy a subscription for a full board-review type program. I didn’t personally, but I’ve heard good things about it and think it’s probably good.

In addition to ZUKU, the other popular online board review site is http://www.vetprep.com. VetPrep is probably more popular, though my guess is that it and ZUKU are pretty comparable.

There’s also a lot of good board review material at this site: http://www.gumshoevet.net. The A-Z Guide (liked to in the left sidebar) is an excellent, quick reference.  A caveat about the A-Z is that it’s getting dated and some of the info is flat-out wrong – don’t believe everything you read! Apomorphine is definitely NOT an anti-emetic.

I’ve heard a lot of stories about how people have studied for boards before me; everything from one student reading the Merck Manual cover-to-cover and another who started, and finished, VetPrep the weekend before. Honestly, I don’t know what was best.

This is what I did: I started VetPrep in mid-August. I printed out the A-Z Guide and had it bound. When I got a question wrong (OFTEN, especially initially), I’d look it up in the A-Z and either highlight or write it in.  I paced myself w/ VetPrep, trying to do about a percent a day, and I did finish it just last Saturday, according to plan. I also took the VIN online class, and it was good. A few weeks ago, I started a cheat-sheet for each of the species, and took notes on the major diseases for each (I wish I had done this earlier, I think).

It’s really, really hard to tell if any one thing was more useful than another. So I’m not sure what advice I could give. I can say that if, God forbid, I have to take the exam again, I really am not sure what I’d do differently; maybe focus more specifically on the top 20 diseases for each species, but I’m really not sure it would be helpful.

I also took the exam on the first day it was offered, in a month-long window. Also, I didn’t take any time off before or during explicitly to study/cram.  It’s possible that another few weeks of reviewing, or a week of empty days with nothing to do but study, might have been worth it; I’ll definitely think so if I didn’t pass! But in reality, I kind of doubt that it would have helped. Cramming would NOT have worked for me as well as slow-and-steady did. And really, the relief of being done and being able to enjoy Thanksgiving and start getting ready for the holidays, is pretty much priceless. Um, unless I didn’t pass.

So in short, I have absolutely no valuable advice whatsoever. All I can say is completely obvious: do the best you can, put the effort it, and don’t leave room for regrets.

As to why it takes them an eternity to get us our scores…the best theory I’ve heard is vet student torture. Because it really does suck – I want to be happy and thrilled and excited that I’m DONE, the LAST MAJOR HURDLE has been jumped, but I can’t because maybe I’m not, maybe I failed and have to do it all over again. So while I desperately try to avoid worry and bad thoughts, I really can’t be too excited that it is over just yet. The exam isn’t scaled in relation to other exam-takers, but apparently some group of people determines the minimum passing score based on exam difficulty – so maybe they at least need to wait for everybody to take the exam to determine that? I have no idea. Annoying.

How it went

My alarm went off at 5AM. For perhaps the first time ever, I had set two alarms – my usual clock-radio and also my cell-phone, just in case. They both went off, and I was up. No snoozing that day.

I got dressed, got awake. I made a healthy breakfast – eggs, turkey bacon, and an English muffin. I had about a half-hour to review, and I chose carefully: epidemiology first, and then a review of drugs – I thought that those were two subjects I could actually benefit from last-minute cramming.

By 6:10, I hopped in the car and drove to pick up one of my best girl friends, who was also taking the test in des moines that day. On the way, I had a quick listen to “Eye of the Tiger”, just to get myself psyched up. Together, she and I went to Starbucks, to load up on caffeine, and then headed south.

We arrived at the testing center just after 7 – very early, but it was actually open. The guy took our IDs, our orange confirmation cards, and had us sign in. We were given huge sound-cancelling headphones and two laminated sheets with two dry-erase markers and an eraser for notes and calculations: nothing else, including watches, were allowed in the room. He escorted me to my computer (#8), punched something into the computer to get it started, and I was off.

I flipped through the tutorial quickly, and then started. I can’t remember my first question – I thought it was something I’d remember forever, and I expected it to be a sign of things to come. I’m pretty sure I knew the answer, but I can’t even remember what species it was in reference to.

I was surprised that the first section of 60 questions took me almost the whole 65 minutes. The timing really was perfect (I was just reviewing answers in the last 10 minutes, and didn’t feel rushed), but I had gone through practice quizzes much faster. I figured it was a good thing for me to be taking more time.

I started the second section just after the completing the first. By the end of that, I was about ready to burst, as I had had a big coffee and forgot to go to the bathroom before I started the test. So I signed out, used the bathroom, and was back for the third section in 5 minutes. By the end of the third section I was staaarving, and so I signed out again, and ate a granola bar. After that I went back and sat through the fourth, fifth and sixth sections.

Then, I was done, around 1:20pm, almost exactly 6 hours after I started. I talked with some of the other classmates who had just finished and were waiting for others. We commiserated, and made plans to meet for drinks when we got back to Ames.

In retrospect, the whole test is a total blur of animals, illness, drugs and toxins; of business scenarios and epidemiology, of PU/PD and not eating and respiratory distress and lameness.  Under duress I could probably recite five of the questions I was asked.

A few things surprised me. First, I really thought that having to sit through even one hour-long section would be torturous. But it wasn’t, really. The time went quickly and smoothly. I wasn’t rushed at all, but I used most of my minutes. And even after the sixth section I didn’t feel completely exhausted or beaten down.

Second, though there were few questions that I had absolutely no idea (one question asked for the mechanism of a drug that I had never heard of, and didn’t even sound familiar), there were many that I could have gone either way on.  Many questions I had narrowed down to two answers and had to guess. There were a lot of “what do you do NEXT” questions that kind of threw me off. For example, a dog who was boarded a week ago comes in for a cough of three days duration, and is otherwise healthy – what do you do next? One of the options was bronchoalveolar lavage, which I liked because then you could get a culture and antibiotic sensitivity, and another option was thoracic radiographs which I liked because you’d want to see the extent and pattern of illness, any other abnormalities, etc, and better to do a $50 procedure than a $600 procedure. Eh.

Third, I felt like I had a ton of epidemiology questions, but they were all very simple. I was really glad that I had reviewed epi that morning.

I don’t know how I did. I felt OKAY about it during the test, but as time goes on after the fact, I find myself second-guessing everything. And with 360 questions, there is no point whatsoever to doing that. My goal for the next two and a half months is to think about it as little as possible.  No easy task.

I really, really hope I passed. It wasn’t as bad of an experience as I feared, but I really don’t want to do it ever again.

game time.

Tomorrow: North American Veterinary Licensing Exam. NAVLE. Boards. 360 questions and 6 hours; broken into 6 even blocks, between which I can take a cumulative 45 minutes for break time.

This is the exam that I have to pass if I want to become a licensed veterinary. Which, obviously, I do.

I think I’m ready for it. I’m as ready as I’ll ever be. Preparing for it has been much like a trip back in time to last year, the year before, the year before that: the stress of preparing for an exam, feeling like no amount of studying will ever be enough has come rushing back and is not exactly welcome.

But as much as the feeling stinks, the lesson I learned then is helpful now, which is: it IS enough. Maybe it’s not enough to get an A, but it’s enough to pass, it’s enough to do well, and that is all I need.

And if it’s not? I take it again. Sure it would be disappointing (CRUSHING), expensive ($600), embarassing and kind of depressing. But, as I was recently reminded, if the worst thing that ever happens in my life is having to retake an exam, then I don’t have much complaining to do.

What comes next

Last week, someone asked me what rotation I’d be on after this rotation and I blanked, completely. The next rotation is after boards, and at the time I was unable to allow myself to even think about after boards.

But now that boards are FOUR DAYS AWAY (AHHHHHHHHH), my brain is slowly starting to acknowledge that there will be a Time After Boards. Which is to say, the rest of my life. And more immediately, the next few months where responsibilities will be minimal and life will be quite enjoyable. And slowly, plans fall into place: I do have a few rotation responsibilities to take care of next week.  I’ve booked a flight home for Thanksgiving (I’ll be home in 10 days! It always sneaks up on me). And then I think of the little things: going to the gym (no really,  i mean it). Getting in shape again. Cooking again, good, healthy food and not just the fasted thing I can make. Shaving my legs (sad but true). Cleaning my apartment like its never been cleaned before. And then the bigger thing: finding a job.

I can’t wait.

impending

I’m starting a new rotation today (Primary Care; one I’ve already taken once and really liked) and I feel totally dull. Maybe it’s that I’m coming off of two rotations, in fact THE first two rotations that I didn’t particularly like. Maybe I’m tired of studying and, more truthfully, worrying about boards (7 DAYS AWAY). Maybe I just didn’t sleep well enough.

For six months I loved my 4th year life and having something new to do every 2 weeks. And now, maybe I’m getting over that a little. Angst over passing boards and finding a job and actually being an independent vet are likely catching up to me, and I’m feeling more like being able to settle down would be really rather nice.

In just seven days, a huge chunk of that angst will be over when I’m done with boards. And everything else will fall into place. In the meantime, I just have to motivate myself to perk up a little.

 

7/8ths

I don’t know how it happened: my 4th year is more than half complete. It has all gone fast, but these last six months especially, have simply vanished into thin air. I remember it all, though some (like that month in May on ICU) is more blurry than others.

Before I had even got into vet school, when I was still in the miserable trenches, I remember saying to a then-1st year, somewhat jokingly: “tell me that it all just flies by and goes really, really fast”. For some reason I thought that it would be so difficult as to make me sufficiently miserable and make time feel like it was crawling. And she said “well, truthfully, it really does fly by”. I don’t know why I didn’t believe her.

These three and a half years have FLOWN. I still can’t really believe that I’m just six months from graduation, that I’m actually going to be a vet.