Check out this great “NEW” medical blog. Blogborygmi started about the same time I did, but stayed “in the closet” until recently. He outed himself to me, so now I’m outing him to the rest of my readers. His writing style is refreshingly clever, less about politics than some medical blogs, and more about the quirks of medicine, such as “Evidence for Evidence based Medicine” and “Full Moon Medicine”. Fun with literature searches!

For those of you who don’t know what the title means, it’s a play on the medical term “Bourborygmi” which is a fancy term for the noise your stomach makes when it grumbles. A blog for grumblings about medicine. Cool.

Like a three-ring circus

Hey, how come nobody gave me a good luck or a congrats on getting past the in-service exam? I’m sure you’re out there, let me know you care! It’s just one more hoop to jump through on the long, long road to board certification. My next hoop is USMLE (US Medical Liscensing Exam) Step 3, working on research ideas, spiffing up my CV and *gulp* starting to look for potential employment! YIKES!

Somewhere in there I’ll get my unrestricted liscense to practice medicine and a Drug Enforcement Agency Number. All of this costs money on top of the outrageous cost of medical school, to the tune of more than $500 bucks a pop for each exam, and license application. (well, the in-service exam was free!). Now 3rd year medical students have to take a clinical skills exam in addition to the first two steps of the board during medical school. I understand the clininical skills exam costs about $900, and each step of the boards is currently costing about $680. That aint small potatoes for anyone, let alone a student with no income!

Personally, I find the clinical skills exam to be an insult to medical schools. Why go through the process of accredidation if all of your students have to pay a grand to have a stranger watch them do 15 minute patient exams?

Ooops, this didn’t start out as a rant against the costs and hurdles of board certification, but it looks like it’s ending up that way. I’d better stop now and get back to the fun stuff I was doing before I decided to blog. Talk to you later.

BTW, I’ll be back in the ICU next week where I was when I started this blog in the first place. I’m sure you’ll get lots of great new stories…real stories, not just a gamers guide to an off – service rotation.


I finally signed up for emergiblogs. I had been too lazy to fill out the form and insert the code into my template, but for lack of any substantial blogging material today, I decided to go for it. Check out the emergiblogs, and add yourself to it!

Tomorrow is the annual in-service exam for emegency medicine residents. All the emergency medicine residents in the country will be taking the exam simultaneously, about 3000 people in total. So wish us all luck!

Gamer’s Guide to OB, Part V of V (final installment)

OK, if you’re really interested in delivering babies on your OB rotation, the first thing you need to know is that “pushing” starts once the cervix is comletely dilated at 10 cm. If there is still cervix left (less than 10 cm dilation), you risk tearing of the cervix, possibly affecting future pregnancies.

Well, last night, a “grand multip” meaning that she had delivered 7 babies v a g inally in the past, came in at 4 cm of dilation. We were sure she would go through labor fast and we’d have a baby by about 11 AM. Well, it was 6pm, and she was still only 9 cm. But she wanted to get that baby out of her belly, so the chief goes in to examine her, and decides to let her push to see if he can push the rest of the cervix out of the way. Well, we all knew she would go fast, but this lady went form 9 cm to delivered with a baby on the bed in about 30 seconds. The chief didn’t even have both hands gloved! (Remember the first rule of protecting yourself!) That was a delivery I was counting on doing, and he knew she’d go fast. He could of at least waited until I was gowned before he asked her to push. I got to delivery the placenta. Ugh. Great learning experience, huh?

Baby #1 of the day, I gave to the medical student, because we still had 2 additional deliveries waiting, and I knew I would be doing one of them. Baby #2 I was gowned and gloved for, and then the chief stepped in with the vacuum extractor, so I didn’t get to take part in that one either. Baby #3 was a C-section so I did not deliver that baby. Baby #4 was the 30 second delivery mentioned above that I SHOULD have been doing, not the chief. Babies #5 & 6 both delivered at about 1:30 AM within 10 minutes of one another and within 5 minutes of each lady getting admitted to the service, so there was no time for anyone to wake me.

SIX deliveries and I did not participate in any of them. Since the triage nurses pretty much ignore the rotating residents and grab the interns, the only choice is to stay awake all night just in case someone comes in who might deliver quickly. Or you can just go to bed.