Week of November 29

The week after Thanksgiving made me realize I was finally making connections with MSK. I felt very happy that I finally understood upper extremity, but this week was difficult.

Monday

The Monday coming back was really difficult for me because we had our fourth FOSCE. This FOSCE was for the HEENT, upper respiratory, and upper extremity MSK cluster exams. Initially, I did not realize that this FOSCE was only focused on the upper extremity. It made me very pleased to know that I did not need to worry about the lower extremity because I could not remember those movements.

For this FOSCE, the instructions would directly tell us what to do for each standardized patient scenario. Next year, they will change that, so we have to determine which exams need to be performed on the standardized patients.

For now, I am incredibly grateful they tell me exactly what to do because I was very nervous for this session.

On this Monday morning, there was a dissection after two hours of lectures. After dissection, I had an hour and a half to prepare for my FOSCE. My heart rate was very high, and I had no idea how or why I was unable to lower it.

I became fixated on lowering my heart rate, but nothing changed while I tried to calm down. The stress and feelings of unpreparedness made it evident to me that these FOSCE scenarios were going to be challenging. In addition, I was unsure of what was included in the HEENT and upper respiratory clusters because there were some differences in the guides and the checklist we were provided.

The actual FOSCE itself did not feel amazing, but I was happy to complete everything I could. I did not introduce myself how I normally would, I felt like I was being more closed off than usual, and I was uncertain of what to ask in my review of systems.

The first scenario was the MSK instructions, and I felt confident in that until I couldn’t remember whether there was strength testing involved. I ended up going back and doing that part and my SP suggested that I close the same exact way again just to ensure I get graded properly. He was super nice, and friendly about everything.

The second scenario was awful for me. I stumbled with introducing myself. I rushed through some questions, and it felt like I was missing pertinent information. I also embarrassed myself with the otoscope and the ophthalmoscope (which I was later told I didn’t need to do!).

For the otoscope, I got the plastic tip stuck in my SP’s ears. BOTH OF HIS EARS. My face was hot with embarrassment because I tried my best to get it to click on. I was also unable adjust the ophthalmoscope, and it took forever for me to finally find the right settings…and I didn’t even need to do that.

I also forgot some important aspects of checking the eyes, nose, and throat which I will NEVER forget.

This SP provided very detailed feedback, and was not as friendly as my other SPs, however, I am very grateful for his grading because now I know where I need to improve.

Tuesday

This Tuesday was interesting for me because I knew I needed to go in for one lecture, but I did the other two lectures on my own time after the lectures. I spent most of that Tuesday reviewing the muscle and bone physiology in detail to try to catch up on studying.

Wednesday

Once again, I found myself waiting for the last minute to get some work complete. This Wednesday night, I found myself still trying to figure out how to write my note for the next morning. I really struggled with it because I had not written a note that included the MSK maneuvers, so I was unsure of how to report those findings.

Fortunately, there were some examples, and our note submissions are after we get feedback on Thursday. From the whole experience, I really liked the MSK cluster exams because it made the FOM lectures make more sense.

In addition to the note, I completely ignored the journal club assignment. I read a few pages and decided that the rest of the assignment for Thursday because it was due before the journal club.

Thursday

The CAS session was focused on presenting our notes and reviewing the notes. In addition, we went over how we felt about the FOSCEs.

After the CAS session, I realized I was very behind on studying this Thursday. I found it difficult to focus on completing the journal club article. Since it was due later that day, I completed it. From the entire experience, I decided to avoid procrastinating from now on.

However, this Thursday was the last biostatistics session. It was rather sad because my biostatistics group helped me understand the material.

Friday

This Friday, there was dissection in the morning and then the fourth weekly case. This weekly case was great because it was about falls, and really showed the importance of inter-professionalism. There were many handouts focused on how to help patients determine whether they are at risk for falls, and how to help them adjust.