WHAT I WISH I KNEW IN 4TH YEAR

Yess! I’m in my penultimate year of medical school….finally. I earnestly look forward to classes and/or ward rounds (this is a lie. I don’t want the holiday to end yet).
As I inch ever closer to the goal that is becoming a doctor, I would like to press pause and take a retrospective look on my 4th year. I did okay but it could have been better.

I’ll begin with the Medicine and Surgery posting. This is the time to have the maximum fun. Classes don’t end very late and you can actually have time for other extra-curricular activities or business. Basically, you can do things other than bury your nose in a book all the time (save this for Pathology and Pharmacology postings). The key is to be 100% present in classes and possibly ward rounds. You’ll learn more this way than skipping classes to just read Davidson’s Principles and Practice of Medicine or Bailey and Love’s. Afterall, medicine is an apprenticeship so showing up is 60% of the work. You could dedicate a few hours of the weekend to going over what you have learnt for the week so reading for the end of posting test is less cumbersome (I didn’t do the weekend reading thing but thank God I borderline survived). M1S1 posting contributes to your final year grade so have fun as much as possible BUT get above 50 for the love of God. Lest I forget, take pictures in your scrub suit!

As for Introduction to Clinical Medicine (ICM) posting, all I can say is attend the classes to the best of your ability. It’s the basis of clinical class and it truly helps. Don’t kill yourself for this. Just get the ICM CD and manual and have a partner to practice with especially close to the end of posting exam. I still don’t know if ICM scores have any significance. Just try to get above 50 ‘just because you can’ even though there might be no reason.

Preventive and Social Medicine (PSM) was definitely one of my favourite postings. It is the bedrock for the PSM done in the final year class. Just try pass am. Be present and you’ve done 80% of the job already as the notes are not so much. You might only have to read it the night before the EOP (end of posting) exam if you do this. If you don’t fancy attending classes, this is the only time I can actually say you could go ahead to skip a few as long as you make up to the required 75% attendance. They don’t play with it. Then, get the notes from someone and try to look at them at least once prior to the night before the EOP. I guarantee you a successful ride.

Finally, Path and Pharm…..the actual reason for year 4. All that I have written above is great but what shall it profit a man to get 70% in all of them (PSM, ICM, M&S) and not do well in P&P? P&P is dicey. You know how I said you shouldn’t kill yourself before? Now, you can kill yourself.

For Pharmacology
Settle on a textbook early on so you can commence reading as soon as possible. For me, Lippincott was my Bible for the Introductory Pharm and System 1 (CVS, GIT, Respiratory and Hemopoietic Pharmacology) and a little bit of Board Review Katzung. I couldn’t deal with the ‘main Katzung’ because it was too bulky for me to cover in such a short time (you could do it but that would mean practically cutting off your social life) and it reminded me of Ganong . I introduced Board Review Katzung/Board Review Series into the mix for the last three postings and barely touched my Lippincott. All I’m saying is, sample the various books if you wish early on and find the one that would be your Bible. There’s no one size fits all so find what works for you and stick to it. Keep your eyes and ears wide open for certain materials that would help you in your end-of-posting MCQS. Don’t be left behind. If you get into the hall for the intro test and you haven’t finished answering the Pharm Intro USMLE questions, then you are a learner.
I made this mistake and I honestly don’t want anyone to anymore. I was told and didn’t listen 😐.

Discuss pharmacology. Teach someone or teach yourself out loud if you don’t have a study partner. Explain the mechanism of action of any drug as often as possible until you internalize it.

Watch Kaplan videos. I didn’t except for one topic and it was truly helpful. Kaplan would reduce the likelihood of you having to dwell on a particular topic before you get understanding. Furthermore, consolidation is enhanced. There are also Pharm audios which you could get from people. You could listen to them when you’re just too lazy or tired to study or when you want to annoy your roommate. They are helpful particularly when you want to multitask. What you hear has a great chance of being remembered when needed. Thus, attend class, watch Kaplan videos, listen to pharm audios, and discuss with someone ….whichever rocks your boat. Just hear something Pharm-related from somewhere or someone.

Get the fabled ‘Drug book’ for drug classifications. I alternated between the classifications in the drug book and that in Board Review Katzung Pharmacology although I took a preference to the latter. Go over the classifications as often as possible as you’re essentially cramming the classification if we’re being honest. Just know that, it might be difficult to scale through a Pharm MB exam if you don’t have a grip on classifications. Just go through any MB past question to see what I mean.

When reading especially the introductory part of Pharm, make notes. It would go a long way when preparing for the MB. Take a critical look at the past questions up to 6 years back and use that as a guide. Common things occur commonly. Answer as many past questions as possible in a 60/80 leaves exercise book to make revision easier.

For Pathology,
You should already know that there are 4 branches that make up the entity ‘Pathology’ – Chemical path, Haematology, Anat Path and Microbiology (MCB)S.
Take the attendance seriously because they do take it seriously. However you want to do it, get your 75%.
Chemical Pathology was my best mainly because they gave concise notes which means your Chem Path textbook might be of no use except you’re gunning for a BGS (even at that, you might still not need it). The introductory part of Chem Path might not seem so interesting because of all the talk about elements Na, K etc but it does get better. Chem Path might be your highest CA like for me and a lot of people. Just read your note as much as you can. They also have the friendliest block posting. Classes end by 1pm most of the time so you can afford to have as much fun as medical school would permit. Just know your Chem path well. It just might be your saving grace!

Chem path practicals….just do whatever you are told to do in the lab. As for the MB, read the Chem Path manual in and out, over and over. EVERYTHING would come from it. Again it just might be your saving grace.

Anat Path –
This is the pathology where knowing your intro like the dorsum of your hand is important. Let your intro always be palpable. Don’t ever get tired of reading acute and chronic inflammation because the lecturers won’t get tired of asking it. As for the block posting, never ever has a study group been so beneficial to me as it was during that period. Taken a look at Robbins and Cotran. That’s how large Anat Path is and it is humanly impossible to finish that book before end of posting test. The best thing you can do for yourself is to be as serious as you can be. This is when you should break you head to make the book enter if necessary. Also, discuss, discus, discuss.
Take the practical classes like a free trip to Paris. Don’t miss it for anything especially the pot sessions. Take pictures of the pots in the lab. All the MB practical questions would definitely come from the pots in the lab. If you don’t utilize this well, na you sabi.

Haematology & Immunology
They account for 60&40 marks respectively. Ensure you get your 75% here even if you might not make it in other courses. There is no begging here. I would say hold your immunology down as tight as possible as it has fewer topics. Ask for areas of concentration. You just might get lucky. The same goes for Haematology. Know all about the Anemias, everything you can know. I’ll admit that I didn’t read my Haematology textbook. If I could go back, I would probably look through it a bit. If you have your class notes on lock though, it might suffice. There’s a trick to scaling through Haematology which I can’t exactly explain here. This is important. Just ask anyone personally (myself included). Haematology was single-handedly responsible for most of the lowest CAs in class so you might as well start praying now. Again, ask for areas of concentration.
Take practicals seriously especially the Haematology aspect. Immunology is quite variable and more unpredictable during the MB.
MCB
I approached MCB the wrong way. MCB is a lot like pharmacology in that you can’t just read it like a novel. This was precisely what I did. I got lucky but that might not be everyone’s story. MCB requires active reading and not passive reading. This will mostly come into play during the block posting.
Try to memorize the name of every organism taught in class the same day it is taught. Follow the lecturer’s pace. This might not be the best time to extensively read ahead. Understand the lifecycles of various parasites and practice them continually. If I had to go back, I would definitely do this. Review, review, review. MCB is very volatile except you plan on reading only very close to the end of posting test in which case your short-term memory might work (I wouldn’t advise this because it could come back to bite you in the ass later on). As for the practicals, be very present and be able to id everything even with the microscope.s
Note -Don’t joke with your seminar presentations. They add to your MCB grade (unlike Anat Path seminar which doesn’t but you should still try to do well ‘just because’). For a lot of people, your seminar topic could be your viva question in MCB.
– Don’t joke with Prof. Obunge’s topics. They are very high yield essay questions.
– Don’t joke with the topics you are taught closest to the end of the posting. They are also high yield.
-Read Dr. Wariso’s textbook to the best of your ability and answer the MCQs at the back (cram them!). They are certainly high yield.
– Don’t joke with MCB. It’s either you know it or you don’t. There’s no in-between.

I honestly wish everyone the best ❤️,
Treasure Chinuokwu.

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My Battle Scars

Okay, I’ll admit it….battle scar sounds a little too serious. I’ve not particularly fought any battle depending on how you want to look at it. As for scars, I’m yet to find out.

This year, I told myself I had to visit a state in Nigeria that I haven’t already visited. It also had to be a gruelling road trip so maybe I could have something to actually remember. Forty-five minutes of flying in the air leaves you bereft of certain experiences you can only acquire when you travel long distance on a Nigerian road. I can fully say mission accomplished.

Blessed by the ASUU strike (yes, blessed…. I’m all about silver linings in the cloud now), I had excess free time on my hands and decided to visit the famous beach in Eket, Nigeria. For those who don’t know, Eket is in Akwa-Ibom. The journey was arduous. It was bad enough that the tour bus I was in was kept on the road for close to two hours by the SARS guys. Want to hazard a guess? I’m pretty sure you’re wrong except you guessed that it was because there was a guy with a tattoo on his arm. Who knew tattoos were illegal? I was going to be a knowledgeable citizen and talk about rights and whatnot, but having knowledge without common sense is like white rice without stew – there’s really no point.

Did I mention that everyone in the bus had to come down and we were searched to check if we had tattoos. Yeah, that actually happened. Again, I didn’t say anything. I just complied. Intro to Nigeria 101 tells you that whenever someone who belongs to the SARS or Nigerian army tells you to do something, don’t question. In case you missed it the first time, seriously don’t question. Like Nike, Just do it! If you don’t, whatever happens….you are truly on your own.

After much pleading and money collection (yes, they still collected bribe money), the tour bus continued on the journey to Eket. I have to say the long ride and annoying traffic at Onne/Eleme were forgotten when my toes touched the sands of Eket beach and the waves rippled against my feet. It was truly beautiful especially at night and to see such beauty in Nigeria in the South where I am from resonated deeply within me. Nothing beats the ocean breeze.

I tend to get carried away so bear with me. What was I even saying about scars again? Yes. It was all fun and good vibes until I decided to run on the beach. It felt like a good workout idea until I fell face flat on the sand. God bless the people around for not laughing. I wasn’t even angry at the moment until minutes later when I felt a sharp pain at my knee. I looked down hoping to not see what I knew I would see. Two perfectly formed circles, one on each knee where my skin had unluckily been scraped off by a jagged stone on the beach. What made it hurt even more was the stinging sea water. I limped back to my hotel room cursing whatever made me think to run by 2am on the beach was a good idea knowing fully well that my vision is not near the vicinity of 20/20.

I had to wash off and clean the injured sites with care. It hurt like hell. Water running down a fresh wound is a terrible idea. It can even make grown men cry. You see, this is the thing. Making something better most times involves a great deal of pain even worse than what you’re trying to ameliorate. It sucks, but as long as you can focus on what your aim is (in my case, wound not laden with germs)….it makes the pain a little easier to bear. It takes a great deal of courage as well. I can say I successfully fought a battle and won..

Nah, my battle was only beginning. I made an unfortunate decision the next day by wearing tight skinny jeans which clung to my knees and of course to my fresh wound which I had failed to dress. I tried and tried and failed but I couldn’t get the damn jeans off later in the day. Luckily for me, an angel in the shape of my friend helped me take them off. My skin which clung to the jean came off as well. I can’t begin to describe the searing pain that ensued. However, some friends do make things a little easier to handle. I might not have been able to get the jeans off on my own. When you have troubles or problems, it’s definitely great to have someone in your corner who could help.

My scars are on my knees. They’re still in the process of formation, wound healing has barely commenced so…..they’re not quite scars yet. Pre-scars maybe? Anyway, can anyone tell me if scars can be prayed away? Nothing is impossible. If this fails, remember what I said about silver linings? The scars would remind me of the amazing time I had in Ibeno Beach, Eket. I’ll come to accept that scars don’t necessarily have to connote something bad. At times, they’re of situations we’ve overcome or good memories that we will never forget because they are literally engraved in our skin.

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September the 18th

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“Beware the ides of March”, Shakespeare wrote eons ago.
Why is this important? It aptly summarises how I feel about the 18th of September. If someone had told me anything about September the 18th a month ago, I would have laughed just as Julius Caesar did because dates are just dates….I used to think. Now, I know better.

If you’re not still sure what the 18th of September heralds, I’ll help you. It’s the day slated for the Part II MB examination.

You know that Bible passage where Jesus talks about the devil coming like a thief in the night? That’s how the MB date came to me. It’s safe to say that I was in shock for some time. I might even still be in normovolemic shock as I write this. I’m not sure anymore.

The only thing I’m sure of is that this MB has to end with shouts of joy. All I can say is, “By all means necessary ‘book must enter’ “. One might have to become a wizard to condense 11 months of excruciating learning into 2 weeks of tedious preparation which has to culminate in success. What other choice is there really?

“P&P will not hold me back!” Can I get an Amen? You can say it out loud if you want.

Pretty soon, the sleepless nights will begin (I really wish I could mumble ‘God forbid’..but there’s truly no other way). I’m ready to embrace the sleepless nights with shaky arms yet, strong resolve. I have done this before.The first MB huddle was crossed, sleepless nights and all. I will repeat this to myself whenever I seem to forget or when the going gets tough. If all these seem to fail, I would make my MB timetable my screensaver so that I never lose sight of the goal. Moreover, Philippians 4:6 will be my daily motivation.

Finally, unlike Julius Caesar, I will not be caught unawares. The 18th of September would not take me by surprise.

PS: 29th September,2017 is also not just another day. It is poignant.
PPS: My Robbins & Cotran textbook is calling out to me. I have to attend to it….sadly.

Static

I’m still angry
That you travelled and didn’t let me know
Why were you in such a hurry?
You didn’t even pack your things.

I’m in your room
You left your light on
How could you?
You always complain about the light bill.

Alright, my anger has dissipated
I’m just wondering
How can I reach you?
You don’t pick up the phone when I call.

I don’t know what to believe
I’m starting to get condolence messages
What does it mean?
I’m still waiting for you to come home.

Your room is still the way you left it
I lay awake on your bed most nights
What do I think about?
How soon I can see you.

It’s been three months now
Maybe it’s true
Are you coming back?
Please answer me.

The silence is so loud
Okay, I think I’ve gotten message
How wouldn’t I?
When the line is static.

I have to give your eulogy
I’m still numb
Could you help me?
Never mind.

I just remembered
How much you loved to make me happy
Why is this important?
I have chosen to be happy.

Your call is never coming
I’ve put down the phone
Was it difficult?
Yes, but I choose to not be sad anymore.

Perfect

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Time and again, you complain
That your voice is hoarse and croaky
That your smile is crooked and shows too much teeth
That your eyes are rimmed with dark circles and eye-bags.

I laugh because,

Weren’t you ever told
That your voice is a cold spring in the Sahara?

How did you not know
That your smile puts diamonds to shame?

You mean you never heard
That your eyes light up more than the sun?

How can you not see how perfect you are?

-Treasure A.C.

Collectibles

The thing about me is ….I’m a ‘quotes person’. I pounce on them and collect them from everywhere, kind of like how a scavenger would. It has always been fascinating to me how a string of words forms coherent sentences which could somehow find a way to pierce the heart deeper than a double-edged sword. To me, the quotes I connect with are an embodiment of this. Indeed, quotes to a writer (maybe, even to the reader) are the equivalent of punchlines to a rapper.

After a huge internal battle, I can boldly write that these are just a few of my favourite quotes.

1. “This is what I like about photographs. They’re proof that once, even if just for a heartbeat, everything was perfect.” ……This is how I unashamedly justify my love for pictures.

2. “There should be no room in your life for regrets. If in the moment of doing you felt clarity, you felt certainty, then why feel regret later?” …I couldn’t have put it any better than Yaa Gyasi did.

3. “A diamond is a chunk of coal that did well under pressure.” ……Suffice to say, I remind myself of this when the going gets tough and I need to trudge on.

4. “Don’t trust everyone you meet. Even salt looks like sugar.” …….my Nigerian mother would love this one.

5. “I refuse to tiptoe through life only to arrive safely at death.” ……now this paints a very graphic image I can’t seem to put out of my mind. It’s engraved in my hippocampus.

6. “..And there will be someone that comes along one day and offers you an entire galaxy when you only expected a single planet.” ……….Do I believe this? Hell yes! I am a hopeful romantic.

7. “Things are never as bad as they seem.” ……I’m too much of an optimist and this line from ‘To Kill A Mockingbird’ aptly captures how I feel.

8. “The process of giving is without limits.” …..

9. “The road to success is not straight. There is a curve called failure, a loop called confusion, speed bumps called friends, red lights called enemies, caution lights called family. You will have flat tyres but if you have a spare called determination, an engine called perseverance, a driver called God, you will make it to the place called success.” …….this sounds like something my pastor would say while the congregation says “Amen! ”

10. “You get one life, so do it all.” – Bobby Axelrod in the TV series #Billions. Yes, yes, yes. Do it all!

If you have a quote you love so much, feel free to share in the comments! ✍🏼. I would love to know about it. Like I said earlier, I’m a quotes person 🙂

Stories Untold

He said, ‘Hi, I’m Dave. I think we’ve met before
She said ‘No’ with a surreptitious smile
He asked for her name. ‘Ada’, she replied with a glare
‘Can I have your number’, he persisted
She sized him up, thought for a second, then gave it to him
And so it began, a couple of calls here and there
They texted all day long, plain words at first
Next, they graduated to emojis and heart smileys.

They went on their first date
It was nothing amazing, but he made her laugh
You know, the genuine kind of laughter
For the first time, she didn’t have to fake enthusiasm
By the third date, it felt like they had known each other forever
He wanted two kids, she wanted four
They struck a bargain. Three was the perfect number
She hated to cook, he loved to cook. It was a match made in heaven.

When he asked her to be his girlfriend, she told him she’d think about it
But she knew that her mind was made up from the first day
Some things you just know
She said ‘yes’ to him on Friday the 14th of March

His friends teased him, calling him a woman wrapper
He laughed, because he knew that a woman like her was like Halley’s Comet
She didn’t mind that he cried when Arsenal lost 5-1 to Bayern Munich
She didn’t mind that on their fifth date he couldn’t afford that restaurant
When he said ‘I love you’, he never wanted to say those words to anyone else.

Two years later, he proposed with a 14-carat diamond
14 to represent the date she agreed to be his girlfriend
She took him home to meet her dad in his home with his second wife
He said she couldn’t get married to Dave. He was Yoruba, they were Igbo.
Dave paid no mind and officially introduced her to his family as his fiancée
His mother said she wouldn’t let him marry someone from a ‘broken home’
He didn’t. He got married to Funmi, who hated that he watched football.
Ada got married to Tochukwu who never made her laugh

June 2nd 2018, Arsenal wins PSG 2-1 in the Champions League final
They remember each other for a fleeting second and look at their spouses.