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AUGUST 15, 2007

It's amazing how much you can start to change over the course of 48 hours.

48 hours ago I couldn't believe I was sitting in orientation in medical school. It's a very surreal feeling being exactly where you've been striving for your entire life.

48 hours later, I'm actually starting to feel like a medical student. I haven't made a single incision in a cadaver yet, haven't seen a single patient, but this week has already started to lay into me the gravity and excitement of the road I'm embarking down. There's been a lot done the past years to humanize doctors, which I think is a good thing, but this week has reinforced to me that medicine truly is a special profession and special calling.

The environment is VERY supportive and rankings and honors are not done on a bell curve. As such, if everyone in the class scores above 90, everyone in the class gets honors. Very cool, and tends to cut out a lot of the competition that seems to permeate medical school.

In a traditional med school format, the first two years are spent loaded with classes necessary to give you all you need to pass your United States Medical Licensing Exam (USMLE) Step 1. You might have a preceptorship, but its primarily in a shadowing format, following around a given physician. Your third and four year are spent in several week long blocks of clinical rotations in the different disciplines of medicine, eventually reaching electives where you are allowed to pursue experiences in tune with your specialization of choice.

My school (though not just my school) does things very differently. The curriculum is integrated, so instead of being loaded up with hours of lecture each day and exams pretty much every week, multiple disciplines are integrated into one "block" (our first block is a combination of gross anatomy, imaging, and embryology). As a result, lecture only takes up the morning, and you only have one exam to look forward to (typically every 3 weeks). This frees up time for what makes my school pretty innovative in my mind: their combination of preceptorship and PCM (Principles of Clinical Medicine).

PCM is a class focused on teaching you the skills to succeed in a clinical environment, focusing on performing the requisite physical exams, proper communication with patients, etc. This PCM is then coupled with a preceptor physician. At my school, one year is spent in 3 rotations of primary care, and the other is spent in 3 rotations of specialties of interest. I find out next Tuesday which block I will be completing this year, though I'm really hoping for specialty rotations this year. Since after your first block you can personally request physicians as preceptors, I'd have the opportunity the really look into the different areas of pediatric surgery I'm interested in.

Since your preceptorship is matched with PCM, MS1s and MS2s are given a much greater deal of responsibility in their preceptor rotations. Thus, I'll have the opportunity to scrub in for surgeries, treat and assist patients, participate (or not since my medical knowledge is basically zilch first year) in rounds, and generally do all the cool stuff I've dreamed of. So not only will I be out on the wards in two weeks, I will actually be DOING things on the wards in two weeks. In fact, the joke around my school is that you're almost loaded with too much responsibility at first, but I'd rather be thrown into the clinical fray right away instead of having to wait two years.

Tomorrow is the white coat ceremony, where we receive our coats "in recognition of our achievements which have granted us the privilege to study medicine." Perhaps a bit melodramatic, but I think that will really solidify the feelings I've had from the first week.

If this much can come in 48 hours, it really will be interesting to see how I feel after 2 weeks, or 2 months for that matter. One thing is sure, I'll be on my way.