IU School of Medicine IUSM Office of Admissions

Carrie Rupprecht, MS1
About Me IUSM Campus:
Carmel, IN
PreMed Major:
Interdisciplinary Science at Purdue University
Little known fact about me:
I like to paint. It's its own kind of medicine.

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Carrie's blog

Lifelong learner of science, art, and fresh spins on kindergarten

Spring Break ’11!!

Filed under: General Life as a Med Student,Specialization Rumination,Step 1 — Carrie Rupprecht on March 17, 2011 @ 10:48 am

It’s been a strangely busy spring break! I’ve tended to numerous chunks of my personal life that I put off when school is in session, like finalizing plans for my move to Indy, buying a computer, and having regular-length conversations with my family. I’ve also been working on a module for a project we’ll be doing with local high school students in April. I haven’t gotten to writing outlines for our upcoming neuro oral exams and have hardly studied for boards like I planned. But I’ve also had some time to relax and have fun. Rock For Riley and the Medical Missions Student Interest Group (MMSIG) hosted a concert at Birdy’s: Trevor Hall with Matthew Santos opening. I wish I could be here for R4R’s main event April 7th!

This month we’re also submitting our preferences for the sequence of our third-year rotations. There are three blocks, each lasting 16 weeks. Medicine consists of inpatient (IP) and/or outpatient (OP) medicine, neuro, and psych. The peds block has IP and OP peds, family medicine, and vacation–but if like 60% of third-years, you take an elective during this time, you can tack an extra month of vacation onto fourth year’s schedule. Or you can save your vacation for last and start your sub-internship early instead. The surgery block keeps us busy with general surgery, ob/gyn, and a surgical subspecialty.

You’ll hear advice ranging from “take no more than 15 minutes to plan your schedule” to emphatic (and sometimes differing) opinions on what to pick and when. I appreciate all of it and am trying to settle somewhere in the middle. Like a lot of med students, I’ve always erred on the side of creating multi-year plans. One of my classmates is the same way: “Want some of my colored markers to mark which sequences are your favorite?” …Yeah, yeah I do.

Anyway, all this got me thinking about which specialty I like, especially since certain electives require third-year prerequisites and so a little extra planning. And I remembered that the last couple times I’ve left the hospital, where I work with mostly elderly patients, I’ve run into kids on my way out. And they cheered me up each time.

Waiting for the elevator, one little girl broke away from her cousins to approach me. “May I ask you a question? …Do you get to go out and pick up people to bring them here?!” I had to tell her no, but my friend does! I loved her enthuasiasm.

As we all stepped into the elevator, one boy looked up and started talking to his sister. They all giggled gleefully as they realized the elevator ceiling was a mirror and talked to each other’s reflection. I’d never noticed! If laughter’s contagious, kids’ laughter definitely is.

Another day, I befriended a little guy wearing an awesome Spiderman shirt: a web was attached to its sleeves and trunk so that it was very impressive when he stretched out his arms. As the elevator doors closed on me, he started crying. I was touched, thinking I’d made an impact, until I realized it was probably because he couldn’t ride on the elevator.

Later at school, a pediatrician reviewed videos and write-ups of our standardized-patient interviews and physicals with us individually. I asked her if examining a child is more difficult. She said no; it is less complicated because they have a cleaner slate: no long list of medications, rarely comorbidities. Also, sometimes a caretaker is the best source of information for a patient too sick to think of everything, and this is certainly the case when the caretaker is a parent.

So I am going to investigate pediatric oncology. While I love the diagnostic process when a patient walks in with what could be anything, I want to specialize because I like to know all the details and explanations, but this is difficult to do unless you stick to one field or two. With oncology, I’d have the chance to help patients feel better and hopefully get better too. Patients who recover may go on to lead long lives. I would strive to be there also for their parents, who might have a greater sense of the gravity of the situation and more worries on their minds in addition to their main concern for their child. I haven’t had cancer, but my mom has had cancer over the years, so in some ways I dealt with it in childhood and know what kind of doctor my mom appreciated having. And I would be able to build relationships with patients and their families, as they’d be there for more than a day; but the goal would be that they not stay too long, either.

Being in pediatrics, whether in a subspecialty or general, may also make me a better public health advocate. Starting with children (and their parents) is the best way to effect change. Sifting through storage over break, I came across a Seventeen magazine from 1969 with an ad for a weight GAIN product. How fast our society can change!

And how fast time flies when I’m writing about specialties. The next two years’ experiences will be the best way to explore them.

Questions and Answers

Filed under: Learning from Doctors & Patients,Satellite Campus Life,Step 1 — Carrie Rupprecht on February 3, 2011 @ 7:32 pm

I’ve noticed that one of my mentors, Dr. Jeffrey Brown at IU Health Arnett, often asks certain questions: “What are the most cost-effective next steps or tests in caring for a patient with [X]?” If X is syncope like a recent patient had, the answer is orthostatic (standing) blood pressure measurement and cardiac telemetry.

Another question he often asks: “How would you summarize that in one sentence?” It’s a great exercise, forcing the student to synthesize information, decide what’s most important, and express it clearly. For example, someone entered the room right as I was finishing my presentation of an article from JAMA’s The Rational Clinical Examination which answers the question, “Does This Woman Have an Acute Uncomplicated Urinary Tract Infection?” At his prompting I succinctly shared with her which symptoms, historical findings, and/or test results make a UTI likely enough to be diagnosed without a urine culture. I used to fear that I wouldn’t be able to explain well what I knew to patients (or to other doctors).

Another illustration of the importance of asking the right questions: One woman had diarrhea and vomiting; she thought she had caught something from her grandson. She confirmed that his symptoms had come first, so I thought her assumption was likely correct. Later, though, I found out from her physician that her symptoms had been present earlier than her grandson’s symptoms and had followed her taking Omnicef. Omni- means “all,” so it kills a lot of the normal bacteria in your gut, letting C. difficile grow unchecked in its newfound space. Vomiting is not a characteristic symptom of C. diff colitis, so I didn’t suspect it and ask the right questions.

Dr. Brown also encourages us to ask ourselves what we like and what we don’t like and to allow ourselves to feel that way. We will better serve patients if we choose our specialties by acknowledging and following what we love.

In other GREAT news, we have our first class baby! We are so excited that our “framily” has become multigenerational. The new baby girl came just in time to get home before the ice, snow, and freezing rain fell–otherwise, our classmate’s first delivery might have been of his own daughter. In an e-mail, my grandma let me know that she was thinking about her mom, whose birthday was Jan. 29, 1897. “Imagine having a baby in a sod house about 15 miles from any town. She was the middle child of thirteen, so I suppose there were family around during the ordeal, oh my!!” This made me thankful for modern medicine and less sorry about my own cabin fever from consecutive snow days. At least I’m in a solid cabin with heating. Besides, these days off have given me time to go through some USMLE World QBank questions and realize that I need to review only a few subjects:
-Cardiac physiology…
etc. I’m thinking that from now on, my blog should be mostly about medical stories or mnemonics which aid in my preparation for boards. For example–the patient with syncope? It was likely due to a combination of overdiuresis, mild aortic stenosis (if the opening of this heart valve is too narrow, less blood gets pumped through it and to the brain), and other factors. I guess the helpful thing about Step 1 is that each question has only one answer.


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