Monthly Archives: July 2009

Almost Healthy

I am praying my zucchini, which has languished in my fridge for a week while I started my new fellowship, is still good. I am making chocolate zucchini muffins. This recipe is fantastic and I have used it before. I am so happy I found it again! I think it’s almost healthy, since it has equal amounts of zucchini and sugar.

In fact, if I ever had a food business or a cooking show, I would call it “Almost Healthy.” Somehow, I don’t think that name would work for a medical practice.

Cross posted at my food blog. (Did you know I had a food blog? I guess I compartmentalize.)

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Mommy Wars Bingo

New Improved Mommy Wars Bingo is on shelves now in the community issue of hip Mama zine.

My friend happened to buy a copy and have it in her bag when she came over! I haven’t gotten one in my mailbox yet.

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What a great day!

I started my fellowship today.

I was about an hour early. My fellow fellow (ha!) told me the main mentor for the fellowship, Dr. F, said to come in at 10 a.m. I was too excited and insecure to come in that late, so I got to wander around by myself for a while. My “bosses”, the three researchers we will be working with, came in at 10 a.m.

Dr. F told us that she wanted us to come up with a plan, and she didn’t expect us to have anything concrete yet. I already have a lot of stuff put together. She also told us she wants some help right away putting together a grant proposal. She wants us to help with a literature search on control groups and ethics. Um, YAY!!! I am such a dork.

We got to sit in on a meeting about on the project on gay Latino men and HIV transmission prevention that is the subject of the grant. Our opinions were taken seriously. I mentioned transgender issues and the researchers and their project developer actually considered them. Part of the project involves a job application workshop, and we discussed if the training could include information on legal names versus transitioned names on job applications, if the gender assigned on the identification does not match the gender of the person interviewing for the position, gender discrimination, community resources and inappropriate interview questions.

The head researcher did say that only MTF transgender subjects would be considered, which indicated to me what her views were on gender identification. At the end of the discussion, she also joked around that no one would want to transition from assigned female gender to a male gender anyway, so it didn’t matter. She elbowed the other researcher, also a cisgender female we’ll call Dr. R, and they both giggled. I think it is more of a “girls rule, guys drool” humor they engage in often, at the expense of the third head researcher, her husband Dr. B, than a commentary on transitioning. But still. Transgender males and their health needs do exist, and could be the subjects of research, not just a joke. But I was happy we did have a legitimate discussion about trans issues for a good five minutes before anyone made any crude or disparaging remarks, and what was said was relatively mild.

Speaking of gender and sex, it was so strange to keep hearing everyone using male pronouns when referring to research and disease transmission. I am usually immersed in reading about birth and women’s issues.

The project manager Dr. R mentioned working at a nonprofit gay and lesbian association for several years, and said she worked at an abortion clinic in the 1970’s! Dr. B talks about health care reform and universal health care in glowing terms, and is a diehard idealist who has worked in the public health corps for years. I told them that I wanted to train them on the bibliographic software I used at my former job, and they sound genuinely interested.

We went out to lunch at the fancy faculty club that I didn’t know existed. It’s like a secret bunker with a pretty restaurant inside. They all left at 2 p.m. The main person in charge, Dr. F, will be gone until Monday. They are all very friendly and obviously like each other a great deal.

The other fellow and I hung out for another two hours or so. Before I left, I checked hipmama and saw that my Mommy Wars Bingo has arrived in mailboxes, in print in the hip Mama zine.

I swam with the family when I got home. I made a kick ass South Carolina Shrimp Boil for dinner tonight.

Life is good.

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Fellowship and call for research

I am off to my first day of my research fellowship today. I dusted off the old white coat and put my mom and baby pin on it. I am really excited about this, and hope I enjoy it as much as I think I will.

I am planning on doing research on doulas, looking at maternal and neonatal birth outcomes, but also looking at other “softer” aspects like autonomy and mental health.

If anyone has any citations or suggestions of peer reviewed research sources, especially on metrics for birth satisfaction, autonomy in birthing, or recent research on doulas, especially with lower socioeconomic women, please post it on this thread or email it to me at hilseb at gmail dot com.

ETA: I had to edit the word “hope” or “hopefully” out of this short post above three times! (I left it in once, see if you can spot it.) I HOPE that is a fortuitous omen for my fellowship.

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Last night of vacation

Tomorrow I start my fellowship.

Tonight we are having a patio campfire and we are making s’mores.

Happy summer!

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Reply turned post, COMLEX and USMLE style

A reader and fellow medical student who blogs at the Dark Autumn Hour asked me why I took both versions of the step I board exams. For most of my readers who are not medical students, especially osteopathic medical students, this question and corresponding blog post may sound like wah wah wah, but it is a huge issue in osteopathic medical schools, so I thought I would address it with an entire post.

Here is just a little background for those of you who aren’t osteopathic medical students and are reading anyway. There are two types of medical school and degree designations for physicians in the United States: D.O. (also called osteopathic) and M.D. (also called allopathic). (There are also two for dentistry: D.M.D. and D.D.S.). I am not going to get into the differences in training or controversies regarding the different designations now. Licensed D.O.’s and M.D.’s have the same practice rights in all 50 states and enter all fields of medicine.

Both medical designations have 3 parallel but separate board exams that one has to pass, step I and II in medical school and step III at the end of residency, in order to become a licensed physician. The osteopathic exam is called the COMLEX, and the allopathic exam is called the USMLE. I just took step I. I took both exams, allopathic and osteopathic.

There are many more allopathic medical schools and residency programs than there are osteopathic programs. Osteopathic students can and do apply to allopathic residencies. The opposite is not allowed. Again, not the topic of this post, but a controversy. When an osteopathic medical student is applying for a residency spot in a pool that includes mostly allopathic students at an allopathic institution, their measuring stick will be the USMLE. Some programs say they will consider COMLEX scores, and some osteopathic students have gotten residency spots with only a COMLEX score. But, in general, for many reasons, many allopathic institutions do not have any D.O. residents in their ranks. So, every osteopathic student in their second year has the option of taking the USMLE in addition to their COMLEX.

OK, here is the reply:

Isn’t that the question on everyone’s minds in the first few years of osteopathic medical school?

I took both for a few reasons. I had to take the COMLEX to finish my school’s academic requirements. However, there are no osteopathic obstetrics and gynecology residencies in my state. I find that especially pathetic, since we have no less than two osteopathic medical schools in Florida. When I first went to the ACOOG website to search residencies, I thought I was doing it wrong. But, no, unfortunately, osteopathic ob/gyn residencies are heavily concentrated in a few states, like Pennsylvania, Michigan, and New York. They might want to reconsider their search by state option, since the vast majority come up empty. (OK, I just checked out the site, and they may have removed this option.)

I am geographically limited. Severely. I have joint custody of my older son, and his father lives about one hour south of me in South Miami. There is only one ob/gyn residency within 6 hours of his house. It is allopathic, obviously. I have heard of D.O.s being accepted there in their internal med program with only a COMLEX score, but I wasn’t sure about the ob/gyn residency. I know of a D.O. student who wasn’t accepted there, and spent a year as a rotating intern, then was accepted for this year. (He is probably starting this week. I need to get his contact info and pick his brain.) Another student from our school matched there, but I didn’t know her and have no idea if she took both exams.

According to APGO, 600 people applied for 9 slots there. I have also heard they grant a maximum of one D.O. slot per year, although, including the intern, there are two this year, both graduates from the osteopathic school I am attending. So, it’s going to be really competitive. I don’t want the lack of a USMLE score to hold me back. (Let’s hope a lousy USMLE score doesn’t hold me back!) I have shmoozed some of the attendings over there and plan to do some elective rotations there, so I hope I have a shot. I will unfortunately be competing with some friends from my school for what may be one or two D.O. slots.

There are a few other programs in Florida, and one in Asheville, NC, I may apply to (my husband’s folks have a house near there, but I may have to go to court to take my older son there). No matter what, anywhere I get in other than the Miami program will involve an alteration in our custody arrangement.

There are many arguments both ways about whether D.O. students should take the USMLE. Each exam costs $500 and takes about eight hours. D.O. students are educated slightly differently, and tend to do slightly worse on the USMLE than M.D. students, and a higher percentage will fail. I took both exams, and in my opinion, the USMLE questions were more difficult. The writing style, vocabulary, the question stems, and the amount of higher level thinking rather than rote memorization was dramatically different between the two exams.

Some of my classmates signed up for both exams. Some ended up taking both, and some changed their minds and didn’t take the USMLE even after paying the substantial fee. We got advice from former students emphatically pushing us in both directions.

In the end, I hope I chose best. I hope my score on the USMLE is adequate. I can always withhold my USMLE score and only present my COMLEX score, if I did better on the COMLEX, but the residency programs will see that I am withholding the score, which is pretty much saying I bombed.

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