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-