Why I'm looking forward to Step 2

All physicians know about the "boards" - they refer to the United States Medical Licensing Examination or USMLE. (There are specialty boards as well after that!)  To become a full-fledged doctor in the U.S., you must take 4 exams: USMLE Step 1, Step 2 CK, Step 2 CS, and Step 3.

Most students regard Step 1 as the most important. Consequently, a lot of preparation goes into preparation for Step 1.  I'll readily admit that I viewed Step 1 with quite a bit of dread.  It's over now, obviously, and I've just begun preparation for Step 2 CK.  However, this time around, I'm actually (somewhat) looking forward to the preparation.  Here's why:

1) It's going to be a great review for intern year.  I'm going into medicine and the bulk of CK is medicine.  And since I've been removed from my clinical years for a while, it's nice to go back to the material.  I'm beginning to dust out the cobwebs.

2) Outcome is directly proportional to effort.  There aren't not too many things like that anymore. 

3) USMLE World. You teach me so much.

4) How cool are mneumonics like CARDIACRIND* and WiLLiaM MaRRoW?**
*Causes of pericarditis:
Collagen vascular disease
Aortic dissection
Radiation
Drugs
Infection
Acute renal failure
Cardiac (MI)
Rhematic fever
Injury
Neoplasms
Dressler's Syndrome

**LBBB: W pattern of QRS in V1 and V2 and M pattern of QRS in V3-V6 vs. RBBB: M pattern of QRS in V1 and V2 and W pattern of QRS in V3-V6

Delightful

I am so delighted and moved by this video.

Summer thoughts

Random thoughts:

1) What is it with kindergarten/elementary school/middle school graduations, complete with cap and gown and diploma?  "Graduating" from elementary school is not an accomplishment. You cannot be Class of 2012 in the 8th grade...no, try making it through senior year of high school and then properly celebrate that accomplishment in 2016. Is this a regional thing or a generational thing? I don't remember any of the sort during my primary and secondary education.

2) I am loving the long days of summer. It's light when I wake up and when I return home, which adds so much productivity and energy to my day.

3) Orange marmalade is bitter, huh? I guess I'm used to Smucker's, which is sweeter than a treacle tart. This TJ's Seville Orange Marmalade is sweet with a distinct bitter edge. I like it.

4) Thank goodness I went the medical school and not the Ph.D route. No doubt, I love research but man, the competitiveness (irony?) and the (lack of) funding. People in my lab have been post docs for 10+ years. 10 years! These are really smart people we are talking about, underpaid, overworked and still chugging away within a very flawed promotion system.

5) I am not ready to return to the wards! I like my research year...let me stay! Can I graduate and just get assigned a residency here and skip the whole application/interview process?

6) On the other hand, I am ready for a change of pace. And a break.  Bring it on, 4th year electives!!!

Strawberry cheesecake

Strawberry cheesecake

First time making cheesecake on my own, although I bought the crusts because I don't have a springform pan. Turned out delicious and very pretty.  Modified from this site.

Recipe below:

Strawberry cheesecake

• 2 store-bought graham cracker crusts
• 1 16 oz box of fresh strawberries (frozen will do too)
• 1 tablespoon cornstarch
• 3 (8 ounce) packages cream cheese, softened
• 1 (14 ounce) can sweetened condensed milk
• 1/4 cup lemon juice
• 3 eggs
• 1 tablespoon water 

In a blender or food processor, combine strawberries and cornstarch and a little water; cover and process until smooth. Pour into a saucepan; bring to a boil.  Boil and stir for 2 minutes. 

In a mixing bowl, beat cream cheese until light and fluffy. Gradually beat in milk. Add lemon juice; mix well. Add eggs, beat on low just until combined. Pour half of the cream cheese mixture over crusts. Drop strawberry mixture by 1/2 teaspoonfuls onto cream cheese layer.  You can save some for serving or use it all up now like I did.  Carefully spoon remaining cream cheese mixture over sauce. Drop remaining strawberry sauce by 1/2 teaspoonfuls on top. With a knife, cut through top layer only to swirl strawberry sauce. 

Place a pan filled with ~1 inch of hot water in the oven.  This is to increase oven humidity to prevent cracks.  Bake at 300 degrees F for 45-50 minutes or until center is almost set. Cool on a wire rack for 10 minutes. . Refrigerate overnight. Thin chilled strawberry sauce with water if desired; serve with cheesecake. Store in the refrigerator. 

Chocolate cake!

My first attempt at making a chocolate cake was a bona fide success!  I modified this chocolate bundt cake recipe from Joy the Baker and oh my gosh, I've already eaten a quarter of the cake.

Because I lacked Dutch process cocoa, I used non-Dutch instead and used baking soda only.  I also reduced the sugar to a little under 2 cups and skipped the glaze part, instead dusting with a little powdered sugar.  The result was a moist, light, and not too sweet chocolate snack cake.  Next time, I think I'll add mini chocolate chips!

Homemade yogurt

Homemade yogurt with honey. Delicious.

Best. Project. Ever. I have always wanted to try making homemade yogurt. I am so delighted that it worked.  I followed the instructions from this site exactly.  At 6 am (yes, I am an early riser but not by choice!) I sidled down to the kitchen and carefully extracted my bowl from the oven. My fingers were crossed the whole way. And yes, success!

The only caveat was that this was not actually cheaper than store-bought yogurt.  I know all the websites rave about how DIY yogurt saves $$$, but I paid $3.69 for a half-gallon of organic milk + $0.50 for a yogurt starter. This made about 3 cups of strained yogurt, not even as thick as Greek yogurt.  At Trader Joe's here, I can buy 32 oz. or 4 cups of Greek yogurt for $4.99.  I guess it'll be cheaper if I buy bulk quantities of milk? But you know what? This was worth the expense and time. I had so much fun and the yogurt was really delicious - smooth, mild, and creamy.

Memorable bits from an inspiring talk given by an inspiring man earlier today:
- "Our job [as physicians] is not only to fight disease but also to fight injustice"
- "We could cure his marrow but we could not cure his hopelessness"
So as future physicians, the road ahead may not be clear to us, but we should not be confused. It is always right to do right for our patients.