Monday, December 17, 2007

Pneumocystis jiroveci is treated with Trimethoprim Sulfamethoxazole

This is just sort of a journal entry slash excuse to waste some time after my huge Microbiology final. It was only 65 questions but covered some 50+ antibiotic drugs and their clinical uses and major side effects, plus some 50+ obscure bacterial and fungal pathogens, their epidemiology, transmission, clinical disease, diagnosis, and treatment. Parts of the class I really enjoyed, such as the tuberculosis (TB) section, but much of it was so obscure and detailed that it required rote memorization. This is probably, for me, the most difficult part of medical school. It often makes me think holistically about how medical schools came about, why we learn it how we do, and what we could do to make medical school easier or more effective.

We spend two full years studying almost entirely from our books, handouts, and powerpoint slides, with very limited clinical contact, and are required to retain the anatomy, biochemistry, physiology, pathology, microbiology, pharmacology, etc. so that we can enter the 3rd year with the tools necessary to treat and manage patients of all kinds largely on our own. During almost every lecture, I find myself just wishing I could meet someone suffering from a Borrelia burgdorferi (Lyme disease) infection so that I could relate more to the humanistic side of the disease, and understand the importance of the antibiotic regimen that will ease their pain, restore their sanity and perhaps save their lives.

I anticipate the satisfaction and excitement of 3rd year that will solidify my clinical reasoning and help elucidate my specific interests in specialties, but dread the upcoming boards (USMLE Step 1 of 3) that function as the gateway into 3rd year, the judgment bar of med school, the standard of comparison by which our future opportunities in residencies will, in part, be determined. My goal is simply to keep as many doors open for as long as possible, because currently I have no idea what specialty I will choose, though I know at least it will be one that allows for more family time. That's what matters most to us.

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