Studying and My Kids

My youngest child started kindergarten today and asked me if I was going to be at his school since I'm in school now too, which was cute :) I then explained to him about how older kids (or--in my case--grown ups) go to different schools.

Me and the kids on a Merry-go-round

I hope with them both being in school now we will have more of a schedule and they will need less *direct interaction at night. The past two weeks I've been trying to make up for them being stuck at home during the day with my dad (who has been taking them for daily playground outings, but they're used to being at daycare all day and having more variety) by taking them out at night or going to the pool, etc.

I am really going to have to start staying and studying in the PA student room. Tomorrow will be a good day to do that, since we're finishing at noon. Studying at home while the kids are awake is really difficult since even though I have a separate study room that they're not allowed in they still manage to interrupt every five to ten minutes. This past weekend was a struggle since they were tired of being in the apartment and the rainy weather from the hurricane meant having to find something to do indoors.

We have a test next Tuesday and have a long weekend coming up (and labor day is my birthday!). My dad is heading out of town to visit my mom and my husband is coming up to spend a day or two with us. Sadly I'm probably going to foist the kids off on him and hole up in my study room and then after he goes back home I'll probably give the oldest child unlimited computer time and rent some Wii games. Not my finest moment as a mother, but it is my best chance at having uninterrupted study time.

I would like to get the bulk of my studying done Friday, Saturday and Sunday day so I can take off Sunday night/Monday morning with Monday evening reserved for reviewing my notes/flashcards. It seems like a reasonable schedule, especially since Friday's classes only go until noon.

*It isn't so much the outings take up a lot of time, but going out for an hour or two pushes back dinner preparations and since we do homemade meals every night and sit and eat together as a family starting later than 5:30 means dinner wraps up right around the time bedtime routines start.

Duke's Reputation in Action

There have been a couple instances over the past few weeks where I have been amazed at the people at Duke.

One of our lecturer's was giving a lecture and mentioned a term for a component of RNA replication. Then he said it should more properly be called something else because they now know more about its make up, but it was kind of his fault that it had the first more vague name because he was one of the people who helped name it. There was also one guy who is now mentioned in basic biology texts who joked about how strange it was that he has been working long enough that he's become of historical interest (not that he was that old! I think he was in his 50's).

And I listen to NPR on my commute and it really surprises me how much researchers are Duke (and UNC Chapel Hill, to be fair) are mentioned. More than one lecturer has mentioned how their lab has been involved in developing/researching treatments that are currently the standard of care for their given areas of research. We had one particularly touching moment last week when being taught about ADA Deficiency with resulting SCID where one researcher was able to share pictures of children who were thriving when two decades ago this was considered a fatal disease.

Movie about Pompe

But today was probably the most impressive moment. We were learning about glycogen metabolism and part of that was glycogen storage diseases. A researcher came in to discuss Pompe Disease, which in its *infant-onset form was fatal (generally before the first birthday). A treatment developed by this team at Duke was FDA approved in April 2006. Before then if your baby had this disease they died, after the treatment if your child was diagnosed they were going to live. The first generation of children diagnosed with infant-onset is out there and show every indication of growing to adulthood (we got to see video of some of the children involved in the first trial and meet a patient with Pompe Disease).

There are still some effects of the disease, mostly with motor function because it causes muscle damage, but nothing compared to what children born even six years ago would have experienced.
People are alive because of that research team. In the space of a few years a disease has gone from a sure and certain death sentence to a completely treatable condition. That's amazing!

*There is an adult-onset version which was much milder form of the disease.

Glucose Metabolism and the Socializing Result

Today's lecturer is awesome. We're going to have him for 9 lectures this week and will be covering glucose metabolism, fatty acid synthesis, gluconeogenesis, the Krebs cycle and everything related to those topics. I'm pretty sure back when I took undergraduate biochem we spent the better part of the semester on this, but I'm sure doing it in greater detail in significantly less time will be fun too. :)

I am glad that the lecturer is funny and has a very approachable style of teaching because this would be a painful week otherwise. And on Friday he's going to do a lecture that summarizes everything he's gone over this week, which will be nice. His material is dominating this week's schedule so I have to imagine it will be a big chunk of test 2. This is a subject that I am fairly comfortable with and I actually like since I am better at biochem than I am at cell biology.

Today class is a little emptier than normal, but surprisingly the med students that closed out the bar with us seem to have made it in (with a few exceptions). It looks like the ones that hung out until 12:30, 1 am-ish stayed home. We were out with the med students  until the wee hours, I dragged into my apartment a little after 3 am so I'm not feeling super chipper myself at the moment. I know I could have stayed home and just streamed the video from the lecture today but I also know that I learn better from actually being in class (and I don't want to get in the habit of not coming to class).

The PA students got added to MS1 email listserve so we should now be getting their group emails (not just about things to do but also things like the note taking schedule). Everyone commented on how happy they were we came out and more than a couple people told us that we needed to spread out in class and that they wanted us to sit more with them. We do tend to sit as a solid block...  I had an incredibly geeky conversation with one med student where we decided that in biological terms that the PA students were analogous to a plasmid inserted into the MS1 genome--incorporated into the whole but of foreign origin.

First Test Done

We won't get our results for a few days because one of the med students has to make it up. I really have to learn to stop second guessing myself. It was torture... Was it A, B, C, D or E (A, B and D but not C)? I swear answers like that are designed to make people doubt they know what they know. There were some things I definitely knew I knew and some I mostly knew and some that I'm sure I knew I knew that I didn't know lol Oh the madness of it all! But I studied quite a bit, and I didn't feel like it was one of those tests where I didn't know anything, which I guess is a good sign. Unfortunately because I did second guess myself I have to deal with wondering if I changed a correct answer to a wrong one... Hopefully not but we will see.

I overheard one of the med students say that she felt like she had studied for the wrong test and none of the questions made sense. Not sure who it was because she was cloistered in a bathroom stall presumably on her cellphone talking to someone who loved her (parent, s/o, sibling, bff, etc), but I felt really bad for her :(

In other news... our class is going out tonight to blow off some steam since after the test we only had a clinical correlation. That means tonight we can all get away without having to study! Also one of the medical students is having a birthday party and we're invited to drop in. Should be fun and we can get to meet more of the med students and desperately try to remember the names of the ones we've met already.

Team Based Learning (TBLs) and blood serum levels

Yesterday we had our first Team Based Learning (TBL) session yesterday. The med students are broken up into groups of six students, but last year the PA students found that having all eight of them together made the group too large. Our class was split into two groups of four. The format is that we have an individual quiz, then do the same questions within our group and then we have an open book/open note/open internet group activity. There are some pretty strict guidelines about what I can and can't share from the TBL lessons, so to be safe I'm going to avoid mentioning content all together.

I was pretty proud of our team, we finished the team quiz before anyone else and got all the questions right. And we knew why the right answers were the right answers and why the wrong ones were wrong, so go us! I missed one question on my individual quiz that was just stupid, as in during the team assessment when we were answering the question I answered it correctly and was surprised when reviewing my personal quiz that I'd put what I put as my answer. All in all, not bad.

The team activity was a bit strange since it was geared towards future medical practitioners, but kind of interesting. We got it all done within the time limit and received full marks for it, so I assume we put enough actual information down that our answers were decent.

The activity does couch questions more in terms of clinical applications, so TBLs allow us to have an idea of real world implications of the information we are currently studying. Although, being honest at this particular point in the course the scenarios that could be given to us would be more suited to the Md/PhD future research scientists track because we're still pretty mired deep in biochem/cell biology.

Also, while going back and looking over the material from last week in preparation of our tutoring session on Thursday (have I mentioned this? I don't think I have...) I remembered that one of our lecturers wants us to memorize the levels of normal blood serum components so that we can better serve our patients in the future. I will do it, because it might be on the test, but I will be grumpy about it. I am pretty sure if you are a physician whose specialty requires you to regularly base clinical decisions on your patient's blood serum levels then you memorize it soon enough through use, and if you're in any other specialty (and I can think of several off the top of my head) that doesn't require you to habitually exam your patient's blood serum levels then you could look up the information if you need it.

But that is just my opinion and I am probably just irritated about it because I'm afraid memorizing that table will take up precious space in my head potentially driving out some other more important information. :-)

So tutoring session on Thursday... because this is our first test and we don't really know what to expect and because they want us to pass and do well, we have a mandatory group tutoring session. It lets us meet one of the tutors and makes us aware of the resources available to us, etc. I'm interested to see how it goes. I know she will be asking us some questions on the material and it will be good to have something to use to gauge my understanding.

Classes...

Oh classes... what can I say? They are fast paced. Really fast paced. Before arriving I'd heard the first  class (officially titled Molecules and Cells) described as a biology degree crammed into 6 weeks and they weren't kidding.

The material isn't impossible, but there is just so much of it. Also, the sheer number of acronyms used is maddening. Our first test is a week from tomorrow and while I am not terrified of it I am very aware that I will definitely have to stay on top of the course materials between now and then. I do not want to be a crammer.

Having children makes studying harder both because of the amount of supervision/interaction they require and because of the time required to keep them fed/clean/healthy. Also not having my husband/coparent living with me doesn't help at all. But my father (thank goodness for him!) is now officially moved in (as are the kids) so hopefully I can neglect them this coming weekend without them actually being neglected.

Sorry for the tangent... back to classes. Molecules and cells is team taught and it is taught in a way that when viewed from a distance makes sense (nucleic acid -->genes --> proteins --> protein folding etc); however, when in class and taking in the information seems like a randomly jumbled mix of biochem and cell biology. The fact that you might have four different lecturers over four different classes in the same day exacerbates the condition. There is no real continuity between individual lecture sessions and it makes it harder to follow the overall narrative. The overarching structure of the class did not become obvious until I started studying this weekend (ie: by being able to look at the classes as a whole as opposed to studying the information from a single class or day's worth of classes).

But other than that, I don't really have any complaints. Of course I might after that first test, ha! I'm learning a lot, and it is staggering how many Nobel prize winners just one of our lecturers has worked with. I really wish I knew how much I needed to study the tiny details. We will have 2-3 questions per lecture hour and some of those hours have covered very complex biological concepts in intimidating detail.

Tomorrow is our first team-based learning (TLB) session and it starts off with our first graded activity of the term. I understand the concepts discussed in the sample questions and I've studied the lectures and notes of the material so hopefully I will do okay tomorrow. :)

Being Social (I will blog about classes this weekend)

I had most of my classmates over for dinner tonight (one girl is training for the Wisconsin Ironman in a month) and it was really fun. I fed them Filipino food and cheese, they brought wine and beer. We talked about classes a little bit, movies, moving, and-of course-the medical students.

I suppose it will be different after we start having labs and start to mingle with the med students more, but for right now we're mostly sitting in class as a block of PA students in class. Everyone is friendly but it sets up an us vs them sort of mentality. Mostly it is the gunners! The folks who ask questions in class not to clarify a point of information but rather to show off their intellectual curiosity or how much they already know. It is hard not to make fun of someone doing that! Generally, you can figure if someone makes it into Duke medical school they had a 4.0 and an MCAT in the mid-30s. Showing off once you've gotten to this point just makes you look insecure.

It was good to get together outside of classes though, especially since right now the other students are the only people I really know in the area! Having classmates I like makes moving to a new place a lot easier :) And they make extremely gracious dinner guests. People pitched in to get all the food laid out and offered to help clean up. Everyone was really willing to try new foods too, which made it more fun. Even the guy who didn't like cheese tried a lot of the cheeses we had.

I want to give my name tag a High-5!

I made it through the first day of lecture (173 slides total). Nothing seemed too bad; although, it probably would have been good to have had human genetics before today... I'm really good with DNA replication because the process is pretty similar in microorganisms, but it is the whole exons/introns thing I didn't get much exposure to. But even with the material not being something that scares me, it is mentally draining to take in that much information in a single day.

I managed to find the PA student room... but it took me having to go up the conference room we used on Friday and then going back down to the second floor rather than just starting on the second floor like a normal person. Once I find a stairwell I feel like I know where I am going. The second years are fabulous and decorated for us! One of them even molded little organs for everyone's cubby. I got lungs (3 lobes on the right one, 2 lobes on the left one) and a very cool name tag.

The first year medical students have been really friendly! There are around a hundred of them and I have to imagine it was strange for eight random people to show up in their class all of a sudden. But several people came by to introduce themselves and we've been invited to join the notes group and get access to the help disc.

Tomorrow we have a clinical correlation lecture where they bring in special guests to discuss specific topics (tomorrow is Sickle Cell Anemia). That means we are required to wear white coats (ha! In addition to taking the med student's classes, we also get to impersonate them) and dress professionally. It is definitely interesting to be learning along side the MS1 and to get the benefit of the education the medical school provides.

Day One Done

After four months of counting down we finally had our first day :-) Yesterday I received a massive binder containing the pathologists assistant program manual and my schedule for the coming weeks and a folder with my lab and team based learning group assignments. These are important things.

And I finally got to meet all of my other classmates! Everyone seems nice and we have a good dynamic so far. Part of the day involved our second years giving us a tour of the parts of the hospital complex that we will be inhabiting and picking out our work areas on the PA student room. The PA student room and the medical amphitheater are the most important places to be able to find so far.

We also received our laptops, sadly even though the med students were issued Macs we were given Lenovo Thinkpads. I was bummed, especially since we pay the same technology fee but I guess I can't complain since it is a laptop. I will be using the external hard drive we were issued a lot though since I had a Thinkpad during my undergraduate years and spent a lot more time in the on campus repair place than would be considered remotely reasonable.

Last night the department hosted a party where our class got together with the current second years, the PAs who will be teaching us, and various faculty. It was a lot of fun and I already adore some of my second years!

Anyway, I have more of the manual to finish reading before class on Monday, so I will finish up for today and report back on Monday after we have our first day of actual class!

Orientation is tomorrow!

Seriously, Hogwarts...

This week has been spent trying to switch from a 2nd shift sleep schedule to a 1st shift one, all in the hopes that I will be awake and functional and on campus tomorrow at 8:30 for orientation!

Right? The bit on the left is castle-y

I had to go to campus earlier this week for my T spot TB test (negative, so I don't have to get another chest x-ray!) which gave me a chance to find the parking garage we'll be using tomorrow. Getting lost would be bad! I also snapped a few pictures of the back side of the hospital/one of the academic buildings. I thought it was really interesting that you could be walking down a hallway and the building around you morphed from modern hospital to comfortable academia. Also, I don't know if any of the readers of this blog have ever been to Duke but parts of it seriously look like Hogwarts (it has both Gothic and Georgian architecture on campus) which then connects to a very large hospital with a massive construction project going on to include more surgical suites and a new area for the pathology department. Right now they get about 50,000 specimens a year (including some very cool complex ones like hemi-pelvectomies) but after the additional surgical suites are added that number will be well over 70,000 specimens a year.

To the right you can see the addition that will eventually house the new pathology department