perjantai 11. heinäkuuta 2014

Life after preclinics and also the 4th semester...sorry this will be long post :)

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It has been for a while when I wrote last time. This will be my second post written only in english. I must first apologize the possible spelling mistakes that I will make during this post. But let start the review of whole 4th semester and then I also include something about my summer job in mental hospital of Harjavalta where I work as a psychiatric nurse substitute.
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Generally the fourth semester was an roller coaster ride that you just wanted to be done with, you know the feeling when you are in the half way of the whole ride and you just hope that it would end soon...well that was generally feeling that I had during this semester :)


But lets start with the subjects after this brief introduction of 4th semester. in RSU As I wrote we ended the anatomy, genetics, histology and latvian language on the 3rd semester and continued with microbiology and physiology. New subjects that we had during the 4th semester were pathology (anatomy&physiology), introduction to internal diseases (communication skills, propedeutics, hematology), radiology, embryology and parasitology (was included in the course of microbiology)

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Microbiology for the 4th semester was generally stressing and a lot of time consuming subject, but in the other hand it is also important subject thinking of following clinical studies. The course included the bacteriological methods, diagnostics of bacteria & viruses and specific most common and serious bacterial species and different viruses. We always prepared for each class three to five different bacteria/virus spp. depending on what was the bacterial/viral family subject during that class e.g. coccus bacteria or enteroviruses.. For the classes we needed to prepare patient case examples that consisted primary symptomps of patient, diagnostics of patient, treatment and prevention specific (vaccine) or non-specific. So actually it needed some time to first invent the case and then how you would treat and what test you should do, so very interesting and at the same time you learned more about the bacteria. Also during classes we had "small" test before the presentations.


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Parasitology which was included in course of Microbiology and the final exam of it consisted different parasites, worms and insects that may cause very nice and wonderful diseases through toxins and via vectors :) In parasitology we also got to draw some nice pictures, but they were not so important from the artistic point of view compared to embryo/histology. Also during classes we watched some movies from youtube about the deadliest creatures of earth that consisted always one patient case example with parasite infection. During the class we learned about malaria, tic born infections, bugs and so on. Generally the course was very interesting and actually giving good balance to the microbiological studies :)

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Physiology continued as 3rd semester. But the general subject was bind to first half consisting cardiovascular system and the other half respiratory, endocrinology and urinary systems physiology. We did during classes spirometry test, our body mass index test with included the fat-% as measured with electricity through tissues, urinary and blood test. So generally educating and fun experiments and after these test we needed to write our protocols that consisted the test results and some theoretical questions of the subject/test procedure.


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Embryology was the last subject that we had in the Anatomicum so I could say after that course good bye to the Anatomicum (until we meet again, but just as making the final exams) :)
Embryology consisted as the name tells study of embryonic life. There we again drew drawings from the slides that we observed through microscopy. The course started from teratology then continued to formation of germinal cells, fertilization, conceptus and then first trisemester, and until the birth. Of course we went through all the developments of different organ systems and main teratogenic effectors.
We drew the drawings from the sperm-cells until whole embryo :) So our artistic properties were good way tested during histology and embryology courses :)


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Then we finally get in to the "good" stuff, so the courses that consisted studies in hospital and some were included working with patients :) So firstly radiology... Radiology course consisted the basics of radiology, what it is , why it is for, what different methods we have, why it is used, which procedures are harming/non-harming and so on. During the lecture we went through small bite of the whole apple of radiology and as the course included in it name that the basics of the radiology, it really was it. During the classes we went through with help of teacher (clinical doctor) the presentation that included the repeat of the basics topographical features, how the appliances work and how we diagnose or interpret the radiological examination result. In one class we had a chance to go through different CT image and try to find first just the organs and recognize different organs in CT-image with the help of teacher.

Introduction to internal diseases was divided to communication skills, propedeutics and hematology. In hematology we generally went very quickly through some key features that we should recognize from the blood picture when we take the lab-tests. The hematology consist of three classes and the courses were held in infection hospital, so we got to see during one class patient with lymphadenoma. So we were lucky ones :)

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Communication skills consist of different methods how to communicate with different patients older, younger, infants, different colleagues and with patient relatives/parents. Each group differs by the method how does doctor communicate with e.g. older patient - doctor vs younger patient - doctor. For the classes we made presentation of different communication methods with patients and my subject was the communication with aggressive and/or alcoholic patient. Also we had opportunity to go to hospital ward to communicate with patients and so test actually the anamnesis morbi (consist patient personal information, information of the diseases, family, pain, genetical and the examination that are done by hospital personnels). During this course I had opportunity to train my russian language and few times I translated the russian to my group mates from the talk that we had with patient. Generally the patient in Riga are capable to speak latvian and russian but sometimes also english. So good advice for the people who are coming to study to RSU/Riga medicine or the ones who are studying here to learn either russian (at least a little, basics...) or the just try to squeeze some more time to learn the Latvian language more.
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Propedeutics was the course that we had after the communication skills and actually this course included the physical part of examination of patient. So we learned percussion, palpation of patient and listen the lung sounds and some basics markers of patient body/attitude/posture etc. This course we also had possibility to go to hospital and listen their lung sounds when the patient was having pneumonia, removed other lung and so on. So this course was very educating i must say, sad that because of the pressure that we had in other subjects especially Microbiology at least i could not concentrate as much as i wanted to this course. But i hope that during the clinical time i can catch up my group mates and semester colleagues with this :)

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Then we had pathology which is divided to pathological anatomy and pathological physiology
courses that will in the end of the 5th semester consist only one exam pathology. Pathological anatomy classes we had in hospital Stradins and there in pathology department, over there we went through the presentation that teacher had and same time observed pathological histological slides that were obtained from patient that then could include different staining methods or different organ systems depending on the subject that we had on that class. The classes were divided first cell pathlogy, then inflammation then the different organs systems and last but not least the cancers. I would say that for this course good pre-knowledge of histology of organs is important and key factor to understand the pathological slides. So if you handle the histo, you will manage this good!  Pathological physiology included the physiological part of pathologies, there we went through also cell destruction, fever, acid-base balance, shock and etc states. These both courses continue to 5th semester so more about them in the next post :)

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Then about the exam period which consisted 4 exams (embryology, microbiology, physiology and propedeutics). I did all the 4 exams that way that first i had embryology then propedeutics, physiology and last the microbiology. The embryology exam consisted for me just multiple choice questions (others: also schemes and slides). The physiology exam consist 3 questions out of 96 questions which then were about the subjects that we had during the 2nd year in the course. The propedeutics exam had MCQ and general part (the examination of patient and some places/marks and methods to observe about the state of patient). The Microbiology exam consisted the 4th semester subjects and parastiology and it had 2 cases (1 parastiology and 1 microbiology case) and 4 theoretical questions.

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Now the fun part, because the 2nd year is really and finally over !!!! :) So im working in hospital for this summer just little bit over one month as a substitute mental health  nurse and over here you really learn stuff more and more each day. I would suggest any medical student to go to work at least once during school as a nurse, because then you also recognize the value that nurses give to the whole your professional life and without them nobody would survive :)

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During the first three days work here I have talked many times with patients, got to introduced with different mental medicine (even remember someones already), got to see ETC treatment and lot of more. The patient that we have in ward are more then 65 years old and mentally unstable from Schizophrenic, manic to depressive patient with different somatic disorders. So very educating :)

I have said this few times, but maybe this time I will write more. Thank you all for the responses that I have had about the blog! Have great summer and new text again after summer holidays!

This song just makes me happy! :)



And then for the finns summer song :) Ei muuta kuin chillaan rannalle!

-Y-





maanantai 3. helmikuuta 2014

Living and surviving in RSU 3rd semester :)


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This will be the first blog text that Im going to make in english. I made choose to do at least one text in english because people have asked for it.

So short story long or vice versa. Last post was about half time of the third semester. Now when I am writing this text the third semester has ended and successfully I passed to fourth semester. So what did the third consist including life in Riga and studies in medicine.

Lets start there where I left it last time. At that time we had just made our first colloquiums for the semester and must say that passing them felt good. We had generally colloquiums about 2/subject except in genetics. 


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So lets begin. In anatomy we went pretty much everything that you could think of. We started from easy respiratory system continued to GIT then checked out the urinary system and in the end we understood the differences between male and female reproduction system (btw. the females are much more difficult then males). Just that this would not be enough we also visited for a while in brain blood vessels so the first colloquium would not be too easy for us :) After this marathon anatomy amount it was easy sliding to the second colloquium which included just the autonomic nervous system and cranial nerves (so everyone already can think that after the first collo this was easy as ....) well... it wasn´t  :) Still the whole course ended to nice final exam where you needed to re-check your previous knowledge from past semesters (1st: bone+lig.+muscles and 2nd: nerves/bv). For the exam im going to tell you little bit later (so if you are interested just scroll down)


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Then everyone loves to hear about Histology, the study of tissues. There the subject went hand in hand with anatomy, it was nice to see e.g. Graafian follicle, Brain sands, small intestine and the glands generally of GIT. I think that at least seeing them in slides may help for the future studies in 4th and clinics because at least now we know how the healthy tissue looks. The only problem in histology was that we had it as a last subject on friday evening (after microbiology and physiology). So any classes that we had my energy levels were about 10% of max. Still somehow I managed past the colloquiums and even the exam. Colloquiums went the same road including the subjects as anatomy, except in second colloquium we had endocrine and reproduction system with urinary system. Histology during these two semesters held some good and bad moments but in the end it was very educating experience. I did not ever though that you could become so good "artist" that during 8 hours you can draw quite good histological pictures so you are able to do the colloquiums, but yeah, thats life...... 


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Next lovely dear subject genetics, which i had already made one colloquium in previous test. We went in the subject about from the repeating the 2nd semester subject more clearly including even more diseases to cancer genetics, which already included some pharmacological substances. In that course I used for the first time book to get the theory info, this was new way to learn the medicine. Kind of funny to say but the first year you can past easily even not looking the book. After that it starts to be more harder :) Genetics we had 3 colloquiums together and i barely survived from the second colloquium. If i need to point out one thing that I learned in genetics and really don´t want to do it again is calculating pedigrees.... So something new and something old, the pedigrees followed me from 2nd semester, but now Im done with it :) But at least I now know how to do Bayesian probability.

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Physiology the subject that you should love in preclinics. Actually I like this subject very much, only problem that I had with it was that first time (except library course) the teacher was not so good in language producing as other teachers. This why the most interesting subject in pre clinics went by the way we say in Finland "with a left hand". This means that the effort that you put in the subject was less then 10% of the whole effort that you but in the all subjects. The problem is that in the 4th semester you could have teacher who is more "active", but as our groups luck always goes, we still have the same teacher :) (this could be bad, very bad, good or very good thing) In physiology we did a lot of interesting test starting from reflex, EEG, vision, hearing, memory test, etc... Generally the test were lot of fun to do only maybe negative thing was that we had to write protocols and from there answer lot of questions that the protocol contained. But when there is something bad there is also good, so during these protocols we learned at least something, because otherwise the classes were almost useless (reason that I gave beginning of chapter). In physio we had 2 colloquiums and the first one contained pretty much the basics of physiology so reflex, AP, muscle contraction, etc and the second memory, vision, hearing and etc. ) In Physiology and Microbiology we will have final exams in 4th semester.


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Microbiology was funny subject. As I written before we analyzed some bacteria, check out some medias and vaccines. During classes we had lot of presentations of different methods, how we do passive immunisation, enterobacterias and immune system activation (humoral&cellular). The Micro contained 2 colloquiums and the ones who did not get grades from 7-> in collos got extra treat final test :) I was lucky and I got the extra treat so some more pressure for the semester (normaly the 3rd semester is said to be the hardest one) so no more life for me on january :)
For the final test (extra treat) I had to answer for the immune response, antibiotics and bacterial cell wall consistence so my variant for the test was luckily easy, and i passed it :)


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We also sadly ended our latvian language lessons for this semester and next latvian course will be latvian medical terminology, yes i know it sounds funny that you have not done the latvian language course that is considered to be including medical words before the clinics start, but sometimes things go that way. For the final day we bought some flowers and chocolate for our teacher and wrote a card to her so she would have memory from us. 


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Now when im writing this the exam period for me is done and i have succeed in passing the semester. The exams that we had was latvian language, anatomy, histology and genetics. For the latvian exam we had small test and oral test that contained prelearned discussion with teacher (monotonic discussion with teacher who says (ja/ne/ok) ). Next for me was the histology exam. This exam was new because well, that was the first exam in histology. It contained three parts 1. 3 questions theory (2nd and 3rd semester subjects), 2. Two slide recognition  (microscopic histological slides ) 3. Schemes (black and white picture where you try to guess what the heck somebody have mended here to draw). For me the questions were endochondral bone formation, gastric and adrenal gland (suprarenal) and slides were cerebellum and lungs, and the schemes were well something from artery-> vein and myelopoiesis :)
The next exam was genetics for me and it consisted 30 mcq and 5 pedigree questions and this was the only exam that i though that i would fail, but no...i got 4 and i must say that i never been so glad of any number, because then i knew that i passed the subject :) The last exam for me was anatomy one day after the genetics. In anatomy i must say that i had good luck, i had the teacher who actually likes us student and gives some slack if you make mistakes, that was good because in my mental state i started to describe fossa media, when i should been describing fossa temporalis (well shit happens for the good ones too ) my questions were heart (bloodvessels), fossa temporalis & infratemporalis communication,walls and content and as a last nice question the male external genitalia (funny thing you can forgot quite obvious things of the genital part even if you have them yourself) :) 


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Then the last thing the life of the 3rd semester. First you dont have it :) You have your books, ipad (books) and library hours. Really this semester was very hard for each of us im sure it, and that is the reason why our group had some casualties during the semester. I have said before that im now in the best group and this group was one of the reasons why I passed this semester. This is why it is very sad to lose few great persons of our group, because they could not make the semester. Generally third semester life is depended a lot of studying hours, but when you have the small time you spend it with friends. RSU third semester is studying and what i have heard is that the fourth semester is similar. So the 2nd year is hard in any medicine school and the reason could be because of so tight schedule , you can still pass it if you just study from beginning few hours at least each day. 


                                          Best group ever!

I hope next text will be before summer vocations and I will be more active here, but who ever knows. Now in the end few nice videos one for the 3rd semester students in RSU and other one for the Finns :)

                                           YOU GUYS MADE IT!