“Encourage one another and build each other up, just as in fact you are doing.”

1 Thessalonians 5:11

This week has been energizing for so many reasons. I had the opportunity to work with our Dean of Admissions, who is also a practicing OBGYN. In a way, it felt like I’ve come full circle. It was the email with his signature stating I had been accepted to medical school that changed everything, and this week I got to learn alongside him in clinic. His passion for teaching was apparent from day one. I was able to practice my physical exam skills, learned how to give injections as well as clean and dress wounds, and was introduced to billing and coding (something we have little exposure to prior to residency). Between patients, he took time to ask questions, see what I knew about a topic and fill in any gaps. It never felt like I was being “pimped”, because there was no doubt in my mind that he cared and he was genuinely curious where I was in terms of knowledge.

What stood out most was his drive for giving back to the community. He had a high school student shadowing him this week, which was something I had never even considered a possibility at that age. He made sure that she was included the entire time she was with us. We saw patients together, talked about life as a medical student, and he always made a point to clarify things for her while talking medicine. Similar interactions I had with physicians as a patient, while shadowing, and during my time working as a scribe were what drew me to medicine in the first place. I look forward to the day where I am in a position to be that person for someone else. Until then, I find other ways I’ve been able to give back have been equally as rewarding.

For the past two years, I’ve enjoyed helping with medical student tours and interviews. I remember my interview day fondly. One of the first year students took the time to sit with us and answer questions while we waited for the day to begin, something which was unique from any other interview I attended. It’s fun to be on the other side of things now and help at least somewhat alleviate that anxiety I remember so well. I’ve also been a tutor for the first year and medical masters courses. In all honesty, I have a sneaking suspicion I learned as much during our sessions as my groups did. Some of the students I’ve worked with are now first years and it’s humbling to think I played a small role supporting them in reaching their goals. When we are so busy, it can be easy to lose sight of the impact we have on others. Though we may make a difference in small ways and never be recognized for them, they will not go unnoticed. As the year continues, I hope to keep remembering to look around me and do what I can to lift others up.

“No other form of communication is as universally understood as touch. The compassionate touch of a hand or reassuring hug can take away our fears, sooth our anxieties, and fill the emptiness of being lonely.”

Randi G. Fine

This week marked the beginning of my OBGYN rotation. I was admittedly nervous at first. I’ve had minimal exposure to the operating room and surgery in general, though while shadowing I was able to observe a couple of cesarian sections from the pediatric team’s perspective. I exhaled a deep sigh of relief when I saw that my first four weeks are in various clinics, while my last two weeks are in Labor and Delivery at a neighboring hospital. Though I am learning an entirely new style of patient interview and working on my patient education skills, the clinic environment is at least familiar. I’ve thoroughly enjoyed my time with my preceptor this week. She is very approachable and took the time right off the bat to get to know me and learn about my interests. When I mentioned I am considering pediatrics and love playing with ultrasound, she immediately set up an afternoon for me to spend working with one of the pediatric cardiologists who performs fetal echocardiograms. I literally cannot wait to see and learn all about them!

I love the unique perspective my preceptor brings to the table. She masterfully walks patients through each step of an exam and does an excellent job educating patients. She takes time to explain what lab tests are being checked and why, what to expect during each step of pregnancy, and always makes sure any questions are answered. I’ve learned a great deal already about preventative care, prenatal care and contraception and look forward to seeing how I grow throughout the rest of the rotation. I feel so much more in my element being back in the clinic setting. We get to see more patients and the time seems to go by so much faster, though I’m working longer than my psychiatry shifts. Unlike in psychiatry, where there are necessary boundaries between patient and provider, in OBGYN I’m allowed to shake my patient’s hand when I enter the room or hold their hand if they become anxious during a procedure. There is something truly magical about a reassuring presence and taking the opportunity to make that connection with a patient can make all the difference.

The ability to get to know my patients, hear their stories and develop relationships with them over time is something that I value in my future career. As a patient, my favorite docs have been those that I trust, that show they care about me as a person, and that listen to my concerns. A couple of weeks ago, my sister took my nephew to see the pediatric ENT who took care of me when I was little. Though it had been over a decade since I last saw him, according to my sister, he still remembered me and told her he wasn’t surprised I was in medical school. Over winter break, my pediatrician took me out to lunch to talk about school and pediatrics. Before we talked about anything else, she made a point to ask about how my whole family was doing. There are no words to describe the influence relationships such as these have had on me. I can only hope to one day make a positive impact on my patients’ lives like they have on mine.

“Two roads diverged in a wood, and I—I took the one less traveled by, And that has made all the difference.” 

Robert Frost

Today marked the last day of my psychiatry clerkship. I had an amazing experience over these past six weeks. Finally getting to interact with patients and be part of the medical team was incredible. Everyone I interacted with taught me a great deal. The residents and attending physicians encouraged us to meet many different patients, trusting us to use our new evaluation skills to gather information, present our findings and suggest a plan for each patient’s care. If we ever needed help or felt unsafe, we knew we could count on them to have our backs. After seeing all our patients for the day, one of my attending physicians would tell stories about anything and everything, each with a pearl of wisdom or advice embedded. Looking back, I think I learned just as much about life as I did about medicine over these last few weeks. Here are just a few thoughts I’ve been reflecting on.

1. Expect the unexpected.

Third year is full of so many new and exciting opportunities. At the same time, it can feel like you’ve been thrown into the deep end. It’s impossible to know what exactly to expect. Every day, every patient, every team and every hospital is different. Over the next year, we will so often be learning new skills and finding ourselves in new environments that it pays to be comfortable with being uncomfortable. I had no clue what to expect when I entered my psychiatry rotation, but in the end enjoyed it more than I ever would have imagined. Each learning opportunity has something new to offer, so make a point to be present and say yes to new experiences. (Someone remind me of this in a few weeks when I’m scared out of my mind before I attend my first delivery or do my first PAP smear!)

2. There is power in silence.

In the hospital, silence is healing. For patients who are sick, anxious and confused, being in a quiet space is calming. A good night’s sleep somewhere peaceful where you feel safe can be enough to tide a patient over while their medications are taking effect. When talking to patients, silence is powerful. It allows patient and interviewer to gather their thoughts, while showing you value what the patient has to say. By utilizing strategically placed open-ended questions, then actively listing while allowing patients to tell their story, you show you truly care about their concerns. We all have a deep desire to feel heard. Sometimes, there is nothing really helpful to be said or done and the best thing you can do is just be there for the patient. So get comfortable with silence. Rather than being awkward, it is much more often empowering.

3. We must learn to use our voice.

It can be so tempting to, like the Ariel in The Little Mermaid, trade our voice for something with more worldly value. Whether it be legs, recognition, status, or power, the alternative is never what it seems cracked up to be. As future physicians, we will often meet patients during one of the worst times of their lives. They will rely on us to advocate for them and amplify their voices. We must learn to use our voices to fight for those who too often go ignored and unheard. We must also not forget to look out for one another and stand up against mistreatment of any form. Medicine is a team sport and we are all in this together. We can’t effectively take care of others if we don’t take care of ourselves.

4. When in doubt, remember Robert Frost.

In the next year, we will have so many decisions to make. We will decide what specialty we want to go into, where we want to do residency and the type of program we want. To me, the options seem so numerous that I get overwhelmed even trying to figure out where to start. What comforts me is that, though it may be difficult to decide, it is possible to succeed wherever I end up. Like the traveller at a crossroads in The Road Less Travelled, the path I choose will be the right path because it will lead me to where I’m meant to be. It may be different than I ever imagined. I mean, I do sometimes wonder if God hears my best laid plans and just laughs. Nevertheless, it will be quite the adventure and I look forward to seeing where it leads me.

“The heart of human excellence often begins to beat when you discover a pursuit that absorbs you, frees you, challenges you, or gives you a sense of meaning, joy, or passion.”

Terry Orlick

One the highlights of my psychiatry clerkship thus far has been getting the opportunity to talk to patients and hear their stories. We start each morning checking in on our patients, asking how about they are doing and whether they have any concerns. After coming back together and developing a plan for the day, we meet as a team with individual patients to discuss their treatment plan and goals for discharge. Often, some counseling is also done at that time. During one particular conversation this week, we talked a great deal about the importance of finding purpose in life. Our patients come from many different backgrounds and have their own unique goals, obstacles, strengths and struggles. What they share in common with each of us is a deep desire to contribute something of value to the world.

One facet of my alma mater’s mission is to help students find meaningful vocation. I’m still learning what that means for me years after I graduated. From a young age, I admired the physicians who took care of me. I was captivated as they explained my treatment plan, what they wanted to monitor me for, and answered any questions my mom or I had. They made sure I was educated about my diagnosis of Turner Syndrome, how it looks for me in particular and gave me the tools to take ownership of my healthcare as I entered adulthood. As I began to explore careers, I kept returning to my desire to serve others and pay it forward by becoming the kind of compassionate physician that cared for me for so many years. That unquenchable thirst for helping others became my purpose. Now that I am in the hospital and have an opportunity to serve patients as part of the team, I couldn’t be happier or more fulfilled. I’m finally able to contribute something meaningful and that is such a great feeling.

My wish is for everyone to find a vocation that gives them a sense of accomplishment and where they feel they can contribute something meaningful to society. There are so many people who go through life unhappy with their job or situation, feeling like they have no direction and haven’t made a difference in the world. It can be distressing to feel you have no purpose or that your purpose is in jeopardy. Those feelings might manifest themselves in different ways with different people. Some may turn to prayer or reflection, others to maladaptive coping mechanisms and others could choose to ignore those feelings and bottle them up. At the end of the day, we never know what others are going through, and a kind word of encouragement can make all of the difference. When faced with the decision to change paths and try a career in psychology or continue to apply medical school while pursuing a medical masters degree, I felt trapped and unable to move forward. I wouldn’t wish that feeling on anyone. My mentor telling me I’d come too far and that she wouldn’t let me give up will stay with me forever. May we never be so focused on what’s ahead forget to look behind and pull one another up. Let us help others to find their strengths and use those to do something good. Maybe then we might just leave the world a better place than we found it.

It’s now August! That means my cousin and the rest of the class of 2023 are about to begin their medical education. I couldn’t be more excited for them. My medical school will welcome the class of 2023 in a few short days and I can’t wait for campus to be full of energy again. I remember when I first arrived in medical school, my classmates and I had many questions like: How do I study? How do I choose a specialty? How do I balance school and life and not lose myself in the mix? No one has all of the answers. That would be impossible. There are many lessons I learned along the way that I wish I would have known earlier, so I thought I would jot down some thoughts and advice with the help of #MedTwitter. I hope you find them helpful!

1. Social media, when used wisely, can be a powerful tool that can help you put forward the professional image you wish to convey. The #MedTwitter community is very active and is a great place to network and connect with individuals with similar interest. People are quick to share stories, advice, information and funny memes. Even if you don’t feel you have something to contribute, give it a try! I know I stayed away, thinking I didn’t have anything meaningful to bring to the table. Somewhere along the way I ended up starting this blog, so either my mind changed or I just don’t care anymore. Jury’s still out on that one.
2. Medical school is an adjustment and that’s okay. You’ve made it this far. You deserve to be here. Give yourself some slack and communicate with your loved ones so they know to give you some grace as well. Know yourself well enough to know when you can’t juggle more commitments and need to prioritize. That shows maturity and will save you much angst in the long run. If you are feeling overwhelmed, it is always okay to ask for help. Reach out to your academic counselors, professors, and friends. Have a low threshold to work with a tutor. People are happy to give you a hand. No one will know how to help if you don’t ask.
3. Start studying early. Break up the topics into chunks and go over a little every day. That will make things seem less overwhelming and allow you to get more passes through the material before the exam. Though you may tweak your study strategies somewhat throughout medical school, chances are that some of the strategies that helped you in the past will continue to serve you well. If it isn’t broken, don’t fix it. There are many review sources that are useful supplements to your lectures. Try the free trials of them to see what works for you and then stick to using those. It doesn’t help to be bogged down with resources.
4. Don’t be afraid to say yes to opportunities. You never know where they might lead. That research project you were offered may turn into a neat poster that you can present at a conference. The people that you meet at that conference might end up being your future bosses or colleagues. Keep that CV up to date. You never know when you might need it and time flies by. A few years down the line, it can be difficult to remember all of the cool things you’ve been doing.
5. In the end, we are all on the same team, working together to provide the best care we can to our patients. Attend lecture, get to know your professors and classmates. Befriend those you meet working in the hospital. The connections you make will last a lifetime. Enjoy every moment! You’re about to get that white coat for the first time, but before you know it you’ll be at Match Day wondering where the last four years have gone. Welcome to the club! We are glad to have you and I wish you all of the best.

“A goal without a plan is just a wish.”

Antoine de Saint-Exupéry

When I was growing up, my karate school would have a challenge for each of us for the summer. If each day we would complete a set of exercises, practicing our techniques, we would be recognized at a fun ceremony at the end of the summer. I now see the genius behind this idea. It shows participants that, by setting small and attainable goals, you can reach your larger goals for improvement in whatever aspect of life you choose. This is a lesson that has stuck with me and can be applied to any situation.

Even in medical school we do this. We are asked to set goals for ourselves at the beginning of each rotation and reevaluate them at the halfway point to check our progress. This week, we have our mid-clerkship evaluations with our clerkship directors. It’s a chance to check in, see how things are going, and to hopefully receive some constructive feedback for moving forward. Over the years, I’ve begun to realize how much feedback is essential to reaching my goals. As a scribe, I often sought feedback on my notes and how I could adapt them so less editing would need to be done at the end of the day. Now, one of my goals is to become more confident and comfortable presenting my patients, so I make it a point to ask my attending physicians for feedback after I’ve had a chance to do so a few times. It can feel uncomfortable and sometimes it’s hard to find a time to bring up the subject, but no one can read minds. You can’t know how to improve if you don’t ask.

My medical school makes a point to ask us for feedback frequently. Our class was the second to go through our new curriculum, so changes are regularly being made to make things smoother for the future. I am continually impressed by how much our feedback is valued and the impact we have on our education. Our class each year elects student representatives who meet with faculty to discuss any concerns or feedback the class may have. When possible, that feedback is often acted on. Our clerkship representatives recently had our first meeting of the year and we were able to provide helpful information regarding our class’s experiences. When we next meet, we will have the chance to update our class on changes that have been made for the future. I appreciate the opportunity as a class to voice our concerns and feel that they are heard. It shows how much everyone here wants to see us succeed and that support is invaluable. As I look toward residency, that is certainly something that I will look for in a program I wish to match into.

“Words are, in my not-so-humble opinion, our most inexhaustible source of magic. Capable of both inflicting injury, and remedying it.”

J.K. Rowling

Growing up, my mom would often sound like a broken record, reminding us for the thousandth time that “It’s not what you say. It’s how you say it”. Of course we would roll our eyes and go on with whatever we were doing, as this was a nearly every day occurrence. Now that I have begun to see patients in the hospital as part of the medical team, this phrase has taken on new meaning.

Communication is such an important part of what we do. We interact with numerous people daily as we see new patients, meet new team members who often come and go, and work together to provide the best care for each patient. That communication looks different when I’m meeting a new patient than when I’m presenting what I learn about my patient to the team. I like to pride myself in my ability to be able to talk to pretty much anyone, but this is a difficult skill and I have lots of room to grow.

It’s difficult to determine how I can best help my patient when they are unable to or decline to answer questions I ask about how they are feeling. Many patients I’ve met recently have had surgery, a tracheostomy, or experienced impaired thinking for a multitude of reasons. As much as I feel stuck when patients are unable to respond or my typical interview tools don’t work, I can only imagine how frustrating it must be to those who want to speak so badly but can’t. Thankfully, most if not all have access to a white board so they can write out what they need or can respond to some of the team’s questions there. It might take longer, but the care shown by meeting patients where they are is invaluable.

These individuals can so easily become overlooked, it’s up to us to give them a voice and pay attention. I might feel awkward presenting to new attending physicians or that I don’t have much to contribute, but I can help with the little things like filling a glass with water, trying to find a missing TV remote, or informing the patient’s nurse that they were experiencing pain and may need another dose of medication. If I can help patients feel heard and understood, at the end of the day that’s what really matters. Then I’ll have done my job.

“You may have a fresh start any moment you choose, for this thing that we call ‘failure’ is not the falling down, but the staying down.”

Mary Pickford

In a few short days, I’ll finally get to say these words: ” Hi I’m Jennifer Tich and I’m the student doctor on your team today.” This is what I’ve been working toward and dreaming of for as long as I can remember. Third year is officially here! I’ve recharged after studying for STEP, had the lovely surprise of getting to spend time with my sister, brother and nephew, and now I’m ready to reenter the clinical world. The thought is both so exciting and so nerve wracking at the same time. It’s been three years since I worked as a medical scribe and was in the clinic every day. Now I’ll get to see things from another point of view, armed with more knowledge and the responsibility that goes along with it.

We are in the middle of our transition to rotations course, which has been a great opportunity to ask questions about rotations, our roles as students, how to navigate the medical record and present our patients. It’s helpful knowing others that have just been in our shoes and learn from their experiences. As someone whose parents are not physicians, the advice I receive from mentors and classmates is invaluable and I am so grateful for their support. As part of the course, we had the opportunity to practice inserting IVs, urinary catheters and nasogastric tubes on mannequins. I had never had the opportunity to learn these skills before, so I was definitely nervous to try. Like I’m sure I will many times this year, I surprised myself and didn’t find the procedures as scary or challenging as I thought.

My first rotation is in psychiatry, which I’m excited to learn more about. Mental illnesses face so many people that, whatever field I go into, I want to be able to gracefully help my patients access the support they need. My college degree was in psychology and I enjoyed our neuropsych course last year, but I’ve taken a psych interview maybe once. I’m starting with a clean slate. I’m going to make mistakes and be confused. I am not, however, going to be afraid to try, to ask questions, or to learn everything that I can to improve and be the best doctor I can for my patients. I can’t wait to take full advantage of every experience I can this clerkship year. Until then, I’m going to enjoy soaking up a few more rays of Virginia Beach sun and catching up with friends.

“Enjoy the little things, for one day you might look back and realize that they were the big things.”

Robert Brault

Hey everyone! It’s been a minute since I’ve posted on here. I took a break to focus on finishing my STEP studying strong. Now that it is finally behind me, I’ve had some time to just sit and breathe and it has felt amazing. If there is anything I’ve learned in the last two years, it is that life doesn’t stop while you’re in school. People get married, people have children, people pass away. Life moves on just as it has all along. We get so wrapped up in our jobs, studying, and working toward the next big thing that it can be easy to forget to stop and enjoy the journey. Before we know it, years have passed by and we wonder where they went.

I just attended my 5 year college reunion and I was surprised how little I remembered of my time as a college student. I certainly don’t remember much about my courses beside chemistry and physics being difficult and that I loved my psychology and writing classes. What I do remember are the Sunday dinners shared with friends, many movie nights during one of the coldest Januaries ever and enjoying beautiful choir concerts from the stage and the stands. I remember the kind professors who took time to explain things after class and offered words of encouragement. The buildings on campus remain the same, but it was seemingly little moments like those that left me a different person than I arrived.

The relationships and memories we make in life are what stick with us, not the things we buy or the awards or recognition we receive, so let’s make the most of them. Let’s be present and maximize the time we get to spend with family and friends. Let’s revisit the hobbies we put on the back burner because we didn’t have time and were too tired. These are the things that keep us alive. Med school is tough, no doubt about it, but we shouldn’t forget to enjoy the journey. I am still not sure where these last two years have gone, but I know I’m going to make the most out of these next two. I can’t wait to fill them with stories, songs and sand from the beach!

“Because when you stop and look around, this life is pretty amazing.”
— Dr. Seuss

Last week, I took a break from studying for Step 1 and took a road trip to present my research at a pediatric conference in Baltimore. Attending my first national conference was so exciting and I loved learning about the work people are doing to improve the health of patients. Being on the other side of things, as a future physician, was nothing short of surreal.

I had amazing physicians growing up who took the time to explain things in a way I understood and who were excellent role models in so many ways of what a physician should be. As a little girl, I would crane toward the ultrasound screen so I could get a glimpse of my heart beating during an echocardiogram. I remember listening intently as my cardiologist described to me how blood flows through the heart and what they were watching for in each image. I still feel the pure excitement radiating from my endocrinologist as he explained each patient’s story when I shadowed him as a college student. For as long as I can remember, I’ve wanted to be like them. I want to be that person for other children. Attending the various sessions at this conference, surrounded by so many individuals with the same goal, made it feel all the more real that this dream I’ve had so long is coming true.

There are days when we are hard at work studying (which feels like every day now during dedicated am I right?) that our goals seem far away. I know I certainly have lots to learn and I’m trying to soak up everything I can for my future patients. It’s these moments though, whether at a conference, in clinic or relaxing with friends, where we are able to take a step back from the hustle and bustle of life and realize how far we’ve come. I hope in the midst of whatever stressors we might be facing, we can find a moment to stop and remind ourselves where we’ve been, enjoy where we are and look forward to the adventures to come.