Archive for tag: boards

Internship Stress

Patient Population

Each clinic has a different patient population they treat depending on their area. At the National University of Health Sciences Whole Health Center - Chicago, our patient population consists of a mix of Polish, low income, and some students. A majority of our patients come to us from Community Health Center, which is a clinic that serves people without medical insurance. Once they are seen at that clinic, most of the treatment is 100% covered when they see us.

We do see some University of Illinois - Chicago (UIC) students, but not a large number. This is due to the fact that UIC offers their students excellent and affordable insurance through the university, which has almost 100% coverage when they see UIC MDs or DCs. We do offer the students 50% off at the NUHS Chicago Clinic for all services that we provide including: chiropractic, acupuncture, physical rehabilitation, and much more.

Internship Stress

Ever since the beginning of my education at NUHS, upper trimester students would constantly say, "Just wait until you are in your internship; it's so much easier." To those people who told me that, I have to say, "LIES!!!" Once you are in your chiropractic internship, you have a new kind of stress -- the stress of what is going to happen when you are finished.

For me, that stress has been decreased slightly due to the fact that I am finished with all my board exams (Part I, II, III, IV, and PT) and that I have job as an independent contractor lined up when I finish. But there is still so much to handle in order to get started as an independent contractor:

  • Your paperwork for your license along with a significant fee needs to be sent into the state.
  • After you receive your license from the state, you need to get an MPI number.
  • Then you need to apply to each health insurance provider you are planning to enrolling with.
  • And you need to buy malpractice insurance.

Photo of contract
The beginning of my contract as an independent contractor when I graduate.

On the business end of things:

  • You need to hire a lawyer and an accountant.
  • You need to get liability and disability insurance.
  • You need to file with the state as a limited liability corporation.
  • You need to start marketing your for your business.

Needless to say, it's a ton to think about, prep for, and the worst part is wait and wait for the state to approve the applications.

I think the reason I have found this process so stressful is because these are things I don't know anything about. I wear my health care hat very well, but I still need some time to figure out how to wear my business hat. Long to-do lists have become by best friend.

Chicago Plus Siberia Equals Chiberia

Welcome back! It has been an interesting and some might say difficult start to the New Year. 2014 has brought almost 15 inches of snow and temperatures around -35º Fahrenheit. As Chicagoans, we should be used to weather like this, but the past three winters have been very mild, so this has been a rough awakening for most people. Hopefully this is the worst of the winter, but chances are we have a few more months of this before we see spring weather.

2014-01-15_snow
Chicago + Siberia = Chiberia!
A snapshot of the snow on my balcony.

With the New Year, I started my 10th and last trimester of my chiropractic education at National University of Health Sciences. This trimester consists solely of my clinical internship with no other course work. I still am enrolled in the acupuncture elective, which will finish up around the end of January or the beginning of February. The material we still have to cover in acupuncture includes: San Jiao (triple warmer), gallbladder, liver, governing vessel, conception vessel, and auricular therapy.

I had a couple exciting developments since my last blog. On December 26th, I received my score for Part IV Board exams. A passing score for the exam is above 375, and some states require a score of 475 in order to practice. Not only did I pass, but also I received a score high enough to practice in any state. Needless to say, it was the best Christmas gift ever!

Since my first trimester in chiropractic school, I have been shadowing and volunteering with Rick Ezgur, DC, at Progressive Chiropractic Wellness Center. Over the past few months, we have been in talks about me joining the practice as an independent contractor. This can be a lengthy process in that there are initial talks, drafts of the contract, negotiations, second opinions, and final drafts of the contract. It is also important to have a lawyer look at the contract to make sure everything is up to par.

As of Tuesday this week, Dr. Ezgur and I finalized and signed the contract for me to join the practice as of May 2014. It was a very exciting day that was the culmination of all the hard work that I have put in over these past three years. Now my focus is on what I will do to get my name out there, market, and advertise about my start at Progressive Chiropractic Wellness Center, which is located on Sheffield Avenue in the north Lincoln Park area. 

Part IV Board Exams

Thursday afternoon, several ninth and tenth trimester interns left for Part IV Board Exams. National University of Health Sciences does not hold Part IV on campus, so most students go to Iowa or St. Louis for the exams. I went to Palmer College of Chiropractic in Davenport, Iowa, for my final board exams. After taking four other board exams, I walked into Part IV with a very different attitude than the other ones. I'm not sure if it was confidence having taken the other parts or just anticipation of board exams being behind me.

2013-11-12_palmersign

Friday morning I had the first part of the exam, which was diagnostic imaging. This exam consists of 10 stations with X-rays, CT scans or MRI scans. After reading the films, I had to answer questions about diagnosis, treatment plan, any needed referrals, additional imaging, or additional diagnostic tests.

Saturday was the difficult day. Case management and chiropractic technique exams were given that day. The case management exam was very similar to many of the practical exams we had throughout school. In the first few rooms, I took detailed case histories on a simulated patient. Following these rooms, I went into a follow-up room, which had more patient information, X-rays, and diagnostic tests that added to the patient presentation. With all that information, I needed to come up with a differential diagnosis, treatment plan, any needed referrals, or additional diagnostic tests.

Following these rooms, I went through several orthopedic and neurologic testing rooms. In these rooms, I was given a list of procedures to perform on the patient, I had to verbalize my findings to the doctor in the room, and answer questions pertaining to the case after.

The final portion of the exam was chiropractic technique. In this section, I was given two chiropractic manipulations or mobilizations to perform on a simulated patient. The chiropractic listing for the patient and the name of the adjustments were posted outside the room, which gave me time to think about set-up and procedure. Once in the room, I performed all the steps up to the actual thrust, and instead of thrusting I stated what my line of drive would be to the doctor that was grading.

The entire exam on Saturday was about two and a half hours long. So by the time I was finished, I was so burnt out mentally. The worst part of the second day of the exams was the wait time after I finished. In order to keep people from cheating or sending answers to students taking the exam on the West Coast, we were sequestered following the exam until all the West Coast students had checked in. But, overall, I think the exam went well and fingers crossed I passed. My scores are posted in late December. For additional information about board exams you can go to NBCE.org.

Happy Halloween

It simply is the best time of the year! Between the costumes, decorations, pumpkins, crisp fall air, trick-or-treaters, candy, and the occasional scare--what is there not to love about Halloween? Nothing, that's what I say. On Thursday, I went to the 17th Annual North Halsted Street Halloween Parade. I saw a lot of repeat costumes of Miley Cyrus and Robin Thicke from the VMAs, Duck Dynasty, and Walter White from Breaking Bad. But my favorite costumes were Pepper from American Horror Story, the twins from The Shining, and Oogie Boogie from The Nightmare Before Christmas. All very well done.

2013-11-04_halloween

At this point in the trimester, pretty much all the tenth trimester interns are finished up with their patient care numbers for graduation. Therefore, all the patient care has been turned over to us ninth trimester interns, including any new patients that come in. I was lucky enough to get a new patient this week that was a National University of Health Sciences alumnus. As an alumnus of the university, you are given free patient care at any of our clinics, which I think is a pretty nice perk. 

This week in my acupuncture elective we covered the spleen meridian. This meridian runs from the armpit to the foot on both sides of the body with 21 points a practitioner can use. Some common aliments that can be treated using this meridian include: enteritis, musculoskeletal pain, and disorders that increase dampness. Another function of the spleen meridian is to cleanse and 'modify' the blood, and it also houses the body's Yi (wisdom mind).

Any additional free time has been dedicated to studying for Part IV Board Exams, which are the following weekend. I will be taking Part IV in Davenport, Iowa, at Palmer College of Chiropractic. The exam covers X-ray interpretation and diagnosis, chiropractic technique, and case management. The diagnostic imaging section covers cases that are commonly seen in practice and cases that should raise red flags. The chiropractic technique section covers cervical, thoracic, lumbar, pelvic, and extremity manipulations. The case management portion covers orthopedic tests, neurologic exam, case history taking, and physical examination. Currently, every state requires Part IV boards to practice except Illinois.

Tri 9 Half Way Point

It's hard to believe that the trimester is more than half over already. Once you are in the last phase of this program, the time really flies. All your professors keep telling you that you need to be prepared for graduation early because even though you don't have class work to do you are still very busy. Busy with boards, busy with electives, busy with numbers, busy with things outside of school, and busy with planning what you will be doing post-graduation.

The patient load at clinic has been steady to busy most days. This is great for all of us interns because we are getting more experience and a good variety of patients. Also, there are little to no worries about finishing our numbers for graduation on time, which is a big relief. Being in a group setting with multiple interns and a clinician to bounce treatments off and get second opinions is great. It also has shown to be beneficial in that everyone has a particular treatment or therapy they are very proficient at. So we are all able to teach and help each other out when it comes to treatment plans and patient care. This makes for a very pleasant working environment at the NUHS Chicago clinic.

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Treatment Room at the NUHS Whole Health Center

The past few weeks in my acupuncture elective course we have learned the lung, large intestine, and part of the bladder meridians. In Traditional Chinese Medicine, a meridian is the belief about a path through which the life-energy "qi" flows. Through needling these points, you are able to either tonify or sedate the balance of qi in the meridian.  The lung meridian can be used for conditions such as cough, chest or shoulder pain, asthma, shortness of breath, palpitations, fever, and many more. The large intestine meridian is useful for symptoms such as bloating, swelling, constipation, emotional stopping-up, headaches, stuffy nose, or musculoskeletal pain. Finally, we learned a point on the bladder channel called BL 13, which is useful for colds, fever, cough, or flu-like symptoms.

The rest of my downtime has been dedicated to preparation for Part IV board exams, which are the second weekend in November. With Part I, II, III, and Physiotherapy now behind me, I am feeling much more confidant going into Part IV. Part IV exams focus mainly on skills learned throughout our chiropractic education including: radiology, physical exam, patient intake, and chiropractic manipulation. More details to come post-exams.