Greetings from the winter wonderland! Today it is like I am living in a snow globe, and it is just beautiful!
Many of my classmates and I have found ourselves comparing this year to last year trying to decide which is better. I think the overall consensus is that the two years are diabolically different each with their own pros and cons. When making these comparisons I think second year is at a disadvantage because we all started first year with no idea what to expect, so there was nothing else to compare it to. I think second year is a bit more challenging because first year set a standard. First year we had stellar professors, made all new friends, and learned to juggle our huge load of classes by the end. Second year sort of feels like the rug gets pulled out from under you. I found that some of the study techniques that may have worked for first year no longer work for second year. First year we had some of the same professors the entire year, so there was no adjustment period to them for second semester. As a first year, I felt very in control of my routine and my study schedule. Every day was pretty simple in that I went to class nearly all day, sometimes had labs mixed in, and studied nearly all the time.
Second year everything is totally different. There is a constant balance between studying and practicing. While practicing is typically not a very stressful thing, it can be stressful in that it requires coordination between schedules, being at school, and availability of pre-clinic rooms. I have almost always been able to get a pre-clinic practice room when I needed one, but there are times when there are labs or proficiencies going on, and we are not able to practice. Practicing also requires patience with your classmates. There are times when I needed to really practice a particular skill and spend a lot of time on it, so I had to ask somebody to sit for me as a patient. Honestly, I would rather speak in front of 1,000 people than inconvenience somebody or waste their time. Thankfully, all of us are always willing to sit for each other because it is always a fair exchange. It truly is amazing that we are always so patient and understanding with each other even when stress is high. For example, last semester in one day we had a pharmacology midterm, a quiz, and a final proficiency. The night before that day, my friend sat for me as a patient for an hour, and I sat for her for an hour. Even when stress levels are high, everyone is always kind and patient. It is pretty awesome.
Speaking of stress, to compare stress from first year to second year, I would say second year is overall more stressful for me. First year was just taking tests and a few practicals, which is something we have all been doing for years. Second year is taking tests and proficiencies. When I take a test, I know how much I have prepared and studied, and I know that in one hour, it will be over. Proficiencies are a whole different animal. Proficiencies require lots and lots of practice on different people. Every person is different, so I may have done a perfect exam on one person and then the next person has a hard time keeping their eyes open and everything gets derailed. As a novice, any small change from your lab partner’s eyes can derail you, so it is hard to truly feel prepared going into a proficiency. We take proficiencies during our assigned lab time, with a randomly assigned person (not your lab partner) and a random grader. The person grading you will be watching you through the teaching tube on the slit-lamp, through the teaching mirror on Binocular Indirect Ophthalmoscopy (BIO), or just watching you. It makes me nervous having someone watch me and taking notes, so I found proficiencies to make me much more nervous than taking tests. Proficiencies also have more pressure involved in that we absolutely have to master these skills. If you fail a proficiency, you will retake it. While it is stressful to know that you have to master that skill, it is also comforting to know you can retake a proficiency (with limitations). The other thing I find to be stressful about clinic skills, is there is not one right technique. It takes time to figure out your own personal technique that works. For example, I found fundoscopy to be extremely challenging. When doing fundoscopy, you hold a relatively small lens (we use a 78D lens) in front of a patient’s eye while looking through the slit lamp. This is a very magnified view of the person’s retina, which means every little move you make causes your view to be in or out of focus. Each of us had to find our own technique for stabilizing our hands while doing this procedure. I thankfully got a tip from some fourth year students to rest my palm on the chin rest and my finger tips on the forehead rest to stabilize my lens. That tip was a game-changer for me!
With all of this talk of practicing, let me explain a bit more what that looks like. For this semester, our class has started a Google doc for people to sign up when they plan to practice to better coordinate our schedules. Last semester we practiced a lot, but it was not as structured. This semester we are required to perform particular techniques on eight different people each week. We are told our assignment Monday morning at 8am and have until the next Monday morning at 8am to complete it. In addition, we are practicing full exams and new techniques we learn in lab. Truthfully, it is a lot of fun to practice and sometimes it can be relaxing. Last week coming back from break, it was fun having nearly the whole class milling about in the pre-clinic practicing. We all had dilated eyes most of the week, but it was fun catching up with classmates and practicing at the same time. This is what I like better about second year compared to first year. Studying can be interesting at times, but it is mostly just sitting in a chair trying to stay awake. Practicing is usually fun and rarely stressful. It is always neat to see someone’s eyes, and you are always doing something different. I also found it relaxing (most of the time) to sit as a patient. It is a time to just sit and relax because you can’t do anything different than sit still and stare straight ahead most of the time. It is nice to be forced to just sit and be still. Anyways, back to what practicing looks like– we practice in the pre-clinic rooms, which are full exam rooms used only for students. Usually you start with a partner, and then once both of you have done the skill you need to do, you find another pair to switch with. It is a good way to learn from each other, get to know each other, and see a variety of eyes.
Another major change I have noticed from first year to second year is that we each tend to have our own schedules this year. First year, nearly everyone is on the same schedule, which is great for group studying, planning meetings, and having lunch with friends. Second year, we all have different clinic and lab times. We also spend much less time in class (probably about ten hours less). I am absolutely loving my schedule this semester. I have no awkward gaps in my day, so I am either all in class, practicing, or studying. I like big blocks of time to do things because I spend less time in transit. For example, if I have all morning off, I can spend the whole morning practicing or studying. Also, as a commuter, it is nice to have everything grouped together. The days we have class, we have all of our classes at once.
In terms of comparisons, I saved the best for last. Clinic is the absolute best thing about second year! I know I am getting my cart before my horse because I have actually only had one day in clinic, but I already know it is going to be awesome! We are assigned a four hour block of time to be in clinic (8-12 or 1-5), assigned our clinic partner, and assigned our clinic attending. For opt II clinic we work in pairs with an attending doctor. We are going to spend these first four weeks learning our way around the clinic and practicing doing exams on our clinic partner. We will spend the rest of the semester examining our friends, family, and volunteers. I am so excited to finally start seeing patients! It is an awesome feeling to be the ones in the clinic hallway with our white coats and equipment bags.
I really feel like this semester is going to be my favorite, so I cannot wait to share more with you as the semester unfolds! Just one week of classes, and I already love all of our professors. It is also exciting for my family members to be asking me when they can call to schedule an appointment to see me! So much to be excited about!