“Long Nights and Short Years”

1. “Long Nights and Short Years” Nathan Fitton OMS IV

2. Background • Who I am • Where I came from • Where I hope to go • Disclaimer

3. Case • 75 y/o WM • Chest pain 10/10 • Fist clenched over chest • Nausea • Diaphoresis • Numbness into Jaw, Left arm/wrist (not hand!)

4. Differential Diagnosis

5. Differential Diagnosis • Acute Myocardial Infarction • Pulmonary Embolus • Pneumonia • Aortic Dissection • Anxiety

6. What’s a DO? • Andrew Taylor Still 8/6/1828-12/12/1917 • Lost 3 children to meningitis and thought there must be more • Osteopathy is “A system of health care founded by Andrew Taylor Still and based on the theory that the body is capable of making its own remedies against disease and other toxic conditions when in normal structural relationship and has favorable environmental conditions and adequate nutrition. It utilizes generally accepted physical, pharmacological, and surgical methods of diagnosis and therapy, while placing strong emphasis on the importance of body mechanics and manipulative methods to detect and correct faulty structure and function” • Treat the disease not the symptom

7. Osteopathy • Currently 70,000 • 100,000 by 2020 • 26 colleges and 34 locations around the country • Widely Accepted • SOMA is awesome • Check it out

8. Roadmap • Getting here to there • Start now • MD or DO • Stay focused on school • Get involved • Write everything down • Research your school • Websites are huge help (avg GPA 3.5/3.6 and MCAT 27) • MSUCOM has advising appointments • Be different • Shadow, learn a language, travel, work....... • Become a whole person

9. Case 2 • 22 y/o AAF • Abdominal pain • 10/10, Sharp • Began around belly button now RLQ • N/V, Fever, Anorexia

10. Differential

11. Differential • Appendicitis • Ectopic Pregnancy • Gastroenteritis • PID • UTI

12. Med School • It sucks • It’s awesome • It’s scary • It’s rewarding beyond belief • It’s expensive

13. Med School • Schools are different but this is similar for the most part • Years 1-2 Pre-Clerkship: eat, sleep(sometimes), study (all the time), relax • Years 3-4 Clerkship: eat, sleep, study (sometimes), learn (all the time) • DO schools typically go all year round with minimal summer break but lighter class load

14. Med School • Important dates • Acceptance letter • White Coat ceremony-summer before • Step 1- summer before year 2-3 • Step 2 PE- anytime year 3 • Step 2 CE- end of year 3 • Apply to residencies- fall year 4 • Interview- winter year 4 • Match/Scramble- February year 4 • Doctor- July 1

15. Med School • Year 1 Pre-Clerkship • Basic sciences • Anatomy, biochemistry, genetics, physiology • Be flexible with study habits • Course packs, scribes • Spoon fed information • Test: 1-2/week • OMM, DPR, Clinical skills • Group involvement • Just as important

16. Med School • Year 2 Pre-Clerkship • Systems based • GI, Cardio, Pulmonary • Test: 1-2 week • OMM, DPR, Clinical Skills • Base Hospital

17. Med School • Year 3 Clerkship • Catch your breath • July 1st of 3rd year • Just took STEP 1 • Core Rotations • COMAT/SHELF exams • Pediatrics, Family Practice, Surgery, Ob/GYN, Psych. • Institutional exams as well • Rotations of interest (schedule early!!!)

18. Med School • Year 4 Clerkship • Taken STEP 2 CE/PE • Audition Rotations • Interview • Schedule is open • The Match • Finishing

19. Life Happens • Good, Bad and Ugly • Support Systems • Stress Relief • Eye on the big picture

20. Stories from the Wards • Not a student • HIPPA • Abdominal Pain • Trust your physical exam skills • Don’t pigeon-hole yourself • COPD • Never rely on others, well almost never • Always trust your gut

21. Stories from the Ward • Googly eyes • Don’t short cut • Attention to detail

22. Stories from the Wards • Incredible highs and lows • Completely wide open professional choices • Able to design practice to what ever you want

23. Pearls • Listen to nurses • Be Humble • Never Correct an Attending

24. Questions