Term 4: CPD

In mid-February, I started term 4. Irrespective of what I had heard from other students, going into term 4, I knew it would be a lot of work. I knew time management would be tested for 16 weeks straight. I do not mean to scare any future term 4 students. This is just to prepare future students for what is to come.

In terms of blogging, I think the best way to organize my perspective of term 4 is to begin with a brief overview, explain the difference between term 1+ 2 and term 4, and discuss each term 4 class in detail. This particular post will focus on CPD. Future posts will focus on Pathology, Nutrition, Microbiology, and I plan to write a post on time management during term 4. If any readers have suggestions or questions, feel free to email me at meyouandsgu@gmail.com and I will try to incorporate ideas into the posts.

Brief Overview of Term 4
Term 4 consists of 4 classes (Pathology, Microbiology, Nutrition, and CPD) over 16 weeks. Students will devote majority of their time studying for microbiology and pathology, which are worth the most amount of credits. Nutrition is a 1-credit, 2 week long class that is placed in the middle of the term directly after term 4 midterms. CPD is a 3 credit class that focuses on communication and physical examination skills. Students are able to improve their patient interviewing skills and practice their physical examination skills on a weekly basis.

Difference between term 1+2 and term 4:
Personally, I think term 1 and 2 courses formed the basic foundation that is needed to understand material in term 4. The major challenge in term 1 and 2 is adjustment to the amount of material presented on a daily basis and getting accustomed to life in Grenada. In term 4, however, I think the major challenge is time management. In term 2, the schedule consists of only few labs/small group discussions per week giving students plenty of personal study time. In term 4, however, every afternoon is filled with labs and small group discussions. So, there were many days I had lecture from 8am-12pm and labs from 1-5pm. So, personal studying time did not start until after 5pm. For this reason, I had to find a way to review the material for the day at a quicker, more efficient manner. I will clearly explain a few methods that worked for me in the next few posts.

Communication Skills and Physical Diagnosis (CPD):
CPD is a 3-credit class that consists of 1 weekly lecture and 2 weekly labs that last about 2 hours. Each lab group consists of about 7 students. Each lab session will focus on one system for physical examination. Students are given 30 minutes to practice the proper protocol for physical examination with their lab groups. Following the practice session, a standardized patient will enter each of the patient rooms. 1 student of the lab group will conduct the patient interview, 1 student will conduct the appropriate physical examination, and 1 student will conduct a summary and closing remarks. As the term progresses, the lab will start writing SOAP notes in 10 minutes. By the end of the term, the SOAP note will become second nature. I was lucky to be a part an awesome CPD group. We all helped each other and always took turns on the role that we played during the patient encounter. I think this was helpful so that we all conducted interviews, learned how to do the physical exam, and learned how to close an interview. Following each part of the patient encounter, the lab group, the clinical tutor, and the patient will provide valuable feedback. I thought the feedback was very important to help improve my communication skills.

Although there are videos that are helpful to watch before each lab session, I am thankful that there wasn't a substantial amount of outside of class work for CPD. There are 2 quizzes each worth 10% of the total grade and 1 OSCE (Objective Structured Clinical Exam) that is worth 40% of the total grade at the end of the term. Each quiz is a team quiz. Each team is responsible for interviewing a patient thoroughly, conducting the physical examination, and closing the patient encounter within 15 minutes. The grade for the quizzes will only be based on the SOAP note. For OSCE, our last final exam for term 4, each student had to individually conduct a thorough patient encounter in 15 minutes. We then had 10 minutes to type the SOAP note. The OSCE exam consisted of 4 patient cases. Each part of the patient encounter was evaluated for the OSCE examination.

Here are a few things that I did to prepare for OSCE and the 2 quizzes:
1) Physical examination was my weakness. So, I watched the videos for each physical examination a couple times and formulated a pattern to follow for each physical examination. For example, irrespective of what part of the body I am examining, I always start with inspection, then check for tenderness/pain, etc.

2) I practiced interviewing my roommates and a few friends. If I practiced interviewing a person who wasn't in term 4, I usually asked them to tell me about their personal medical history or gave them some sample SOAP notes to read that are provided by the CPD department and asked them to act like a patient.

3) I made up a mnemonic to help me remember each part of the interview. I used this mnemonic throughout the term to make sure I asked all the necessary questions during each patient encounter and it worked like a charm.

4) TIMED MY INTERVIEW!!! Initially, we were given 15 minutes to interview during the lab sessions. By the end of the term, the instructors expect that students interview in about half the time. The more you practice the interview, the better the interview will be. During both quizzes, my team decided that I would be the interviewer. So, I started cutting down my interview time early in the term.

5) For OSCE, I tried to break up my 15 minute patient encounter as follows: 8 minutes for interview, 5 minutes for physical examination, and 2 minutes to close the encounter. This is just a rough idea. The timing also depends on how much the patient talks and the type of symptoms.

6) I became familiar with the differentials provided for each case that we had for each lab session. That way, as I interviewed the patient, I could ask pertaining questions to narrow down my list of differentials.

7) I listened to strategies my lab members used to ask questions during the patient interview and tried to incorporate ideas into my own interview. This helped immensely. Because this is a communications class, it is definitely helpful to learn from classmates.

8) Bring a watch that is non-digital to both quizzes and OSCE. During the quizzes, have one person in the group who is not interviewing tell the interviewer when 5 minutes have passed. Prior to each quiz, my group had decided that if I (the interviewer) spent more than 8.5 minutes interviewing, the person timing must notify me immediately.  This way, we had enough time for physical examination and closing the patient encounter. During the OSCE examination, there was a big clock in each room, so I had a rough estimate of how much time had passed during each patient encounter.

I hope this post provides a general overview of CPD. I thoroughly enjoyed CPD because it helped me connect textbook material learned in other courses to the clinical world.

Hope everyone is having a great day! :)

~N 

Catch-up, Term 3, and Grenada Adventures

Update from N:

Administrative Note:
I know when I started at SGU, I had a million questions that were unanswered until I started the work. So, this blog has the sole purpose to provide tips to incoming students, prepare students for class, and give insight on my perspective of my time in Grenada. I understand SGU is in the process of making changes to the curriculum. This blog will focus on experiences that I have as a medical student in Grenada. I plan to incorporate certain aspects of my life such as meal prepping into this blog, but the main focus will remain on medical school. If you have any questions, comments, or suggestions, feel free to email me at meyouandsgu@gmail.com.

Personal Spiel:
Over the course of term 3/4, a number of events took place in my life. Despite all that has taken place, I've learned that regardless of good or bad, it is important to remember the people who will always stay by your side. Medical school is not easy for anyone. There are days that your slide presentation for pathology goes extremely well and you ask excellent questions during the interview in CPD. However, there are also days filled with frustration and anger. So, I truly value those who talked to me and stuck by my side even if I had a horrible day. I just want to take a moment and thank my amazing family, my college roommates, and some of my best friends from high school who make up the best support team a girl could ask for. Also, to those that have continued to read the blog while I worked my way through term 4, I greatly appreciate your interest in the blog.

Ok, now for the actual catch-up on life:

In December (which seems like a century ago), I completed my term 2 finals, flew back to the US for the holidays, enjoyed my mom's fabulous cooking for a few weeks, and definitely caught up on some much needed sleep. Personally, I thought the end of term 2 was harder than anticipated. In addition to the three finals that I took (Immunology/Genetics, Physiology, and Neuroscience), term 2 students are also required to complete a OSCE examination and BSCE 1. The BSCE 1 is a end of year 1 of medical school exam. It is 4 hours long and integrates concepts from all classes taken during the first year of medical school. Although it does not go on any transcript, I think the result is valuable information to have as I prepare for future board exams. The results are systematically broken down by subject so students can clearly see their strengths and weaknesses.

At the beginning of January, I flew back to Grenada and started term 3. This specific term is 6 weeks long. Although there are 4 lectures per day and periodic small group discussions, students tend to have more time for themselves during this term. So, it is advisable to use the time touring the island and relaxing before term 4. There is a diverse array of material that is covered during the short term. A few of the main topics covered are as follows: Psychopathology, Biostatistics, Universal and United States Healthcare Systems, Bioethics, Epidemiology, Healthcare Law, Human development, Behavioral and Cognitive Development, Behavioral Sciences. 




I kept up with lectures for Term 3 and also made a ton of charts for all the diseases that are covered. The charts helped me easily differentiate between diseases, which helped me answer questions on the exam.

The following are some tips for surviving term 3:
1) Keep up with lectures. The midterm and final tend to sneak up quickly. Majority of the lecturers do a fantastic job highlighting the important information.
2) The small group discussions do not require much prep work, but do pay attention to the topic. There will probably be questions on the exam associated with material covered in small group.

3) If you are anything like me, find a way to organize all the diseases so that you can quickly identify the subtle differences between 2 disorders. This will become helpful on exam questions. For me, this meant making charts. If you have read my previous posts, as usual, I put the charts up on the wall. I frequently looked at the chart and then was able to pin point key differences between disorders.
4) have fun in term 3 because before you know it, term 4 will start. If you have time, it wouldn't be a bad idea to start skimming through pathoma (in my opinion, a must have) for term 4.
5) Term 3 students have an option of visiting the mental hospital in Grenada. I would highly recommend this experience. During my visit, my group was able to hear personal stories from 2 patients that were admitted to the facility.

The following are a few pictures from places I visited during term 3:
1) Seven Sisters Waterfall - Highly recommend going on a sunny day and take a tour guide.



                

2) Turtle watching - One of the best things I have done on the island to this day and would highly recommend it! People travel around the world to see leather back turtles lay eggs on the beaches of the caribbean islands. So, this is definitely a bucket list item.

3) River-tubing: lots of fun if you go with a lot of people. Just be prepared to get wet! (Sorry, we weren't allowed to take cameras, so I don't have pictures)

4) If you haven't done so already, visit the cliff on campus.
    

5) Visit Fort George:


I personally thought term 3 was straight forward as long as students keep up with lectures. My next few posts will provide tips/recommendations and my perspective of term 4 courses (Pathology, Microbiology, CPD, Nutrition). If there are any particular questions on term 4, please email me at meyouandsgu@gmail.com. I will address the questions in my next few posts.

Hope everyone is having a great summer! To the SGU students that started term 3 today, good luck for the upcoming term! :)

-N