"Back in Beer Sheva," by MSIH first year blogger Tamara Kliot

Coming back from break is always a transition. It takes time to get back into the study grove, let alone get yourself back on the right sleep schedule. Jet lag is rough and a constant battle between when you should and could go to sleep. Balancing that battle alone with the introduction of new classes can be a challenge, but that’s part of the package when you decide to go to medical school in a time zone 10 hours ahead of home or decide to create a home 10 hours ahead of where you grew up. However you see it, time zones are hard to traverse. I guess that’s something most of us interested in global health will grapple with for the rest of our careers.

Luckily, we had some engaging lectures to start off the semester. We had your typical physiology, pharmacology, and genetics classes. However, we also had the opportunity to participate in a Mind and Body 3-day elective facilitated by Dr. Haramati. This elective was focused on self-care practices, such as meditation, and could not have come at a better time.

Medicine is an intense profession that requires a lot of time and effort invested in learning and even more on other people’s problems. It’s stressful and overwhelming at times. Doctors are known to be the worse patients and it’s a widely held belief that they don’t always take care of themselves properly. This elective was a good reminder of this and introduced or re-introduced students to practices that they can integrate into their schedules.  Mind and Body also allowed students to connect with each other in a different space (more literally than physically because we were in our normal classroom). It forced many students out of their comfort zone, but the result was empowerment.

With week one done, jet lag almost beat, and the opportunity to hear about the fun things my classmates did over their 10-day break, I can honestly say I am excited to be back in the B7 and ready for what this semester has to offer. New classes, modules (I’m especially excited for nutrition and disaster relief), global health speakers, experiences, and adventures to come. There is also a lot of familiar things that will make this semester easier than last. We’ve come a long way class of 2019 and I am excited to see where we go and the opportunities we find to push our own development as future doctors in the next couple months.

"Surviving Exams" by MSIH first year blogger Tamara Kliot

We finished our first semester exams and are currently on break. As I flew back home, I couldn’t help but think, that means I’m 1/8 an MD! For many of us, this day felt so far away. Exam grades are trickling in and second semester of medical school is becoming an approaching reality.  I have been able to reflect on this past semester with some distance between those intense weeks of eat, sleep, study, exam, repeat. Here are a few tips to survive first semester exams (to future 1^styears)!

1.      Draft a Supportive Team

The amount of information you are expected to know come finals is well, to say the least, a lot and a bit overwhelming. It is close to impossible to catch all the important details mentioned in class and studying this vast amount of information is much more fun when you are around other people. Find a few people in class that you can study with, be it talking about material you don’t understand, reviewing the stuff you know, teaching each other concepts, or just sitting next to each other while you each work in complete silence. Exams can be overwhelming and isolating, but it doesn’t have to be if you find the people you work best with and develop a plan. Check out this fun picture a friend drew while I was studying immunology! I will never forget the unique mechanism Tuberculosis uses to evade the immune system.

2.      Visit the Shuk Often

It’s really easy to fall into unhealthy eating habits during finals. I don’t know why, but I’m always craving large amounts of sugar and salt when exam time rolls in.  Cooking becomes more of a hassle and vending machines seem like a good alternative. Going to the Shuk is an awesome way to fill your refrigerator with brain food. With tons of fruits, veggies, and meats there is bound to be something you will want to eat. Going to the Shuk is also a great way to stay connected with reality, since its always bustling and full of life on Friday mornings. There’s no better snack then fresh strawberries from the Shuk to jumpstart your studying, I’m mean just look at them.

3.      Take Breaks, Unplug, and Recharge

You can’t study all the time. You’ll burn yourself out at some point. Take some time to “do you”. Be it hosting a meal with friends, having dinner at your favorite pizza place, playing bananagrams (my personal favorite), going to the gym, running  through the Narnia of Beer Sheva, or taking a trip to Jerusalem to learn more about infectious disease control. Figure out what you need to do to recharge before exam day and make time for it. Check out everyone’s’ smiles on a mandatory study break our class had in Jerusalem.

4.      Find a Good Study Spot 

When classes end and self-structured studying becomes your 9-5 (or much later) job, its important to find a place where you can focus and work, a place that fits your study habits. For some, studying at home is great, but for others leaving the distractions of their apartment is important. If you like to draw things out, find a classroom. If you like to talk it out, find a public space or coffee shop. If you like complete silence, check out the libraries on campus. You might have to get a little creative during Shabbat (as the library and many other places close), but finding a place you can study consistently is crucial for exam success.

5.      Practice, Practice, Practice

No matter how well you think you know the material, practice is key. We have a lot of NBME (National Board of Medical Education) style final exams and there are loads of practice questions you can do that are written like the ones you’ll see on the final and again on the Step 1.  The only way to stay calm and destroy finals is by knowing your enemy (the exam) really well. Don’t be scared and throw yourself into questions as early as possible. You’ll be thankful you did later.

"I get by with a little help from my friends," by MSIH blogger Tamara Kliot

With classes done and exams in full swing, we have an opportunity to reflect on what has happened over the past 5 or so months. We have learned about the important enzymes that allow us to metabolize nutrients and sustain life, the battle that occurs inside us every time we are invaded by foreign pathogens, the intricate design of cells in different parts of the body, the bacteria we should love and hate, the true meaning of statistical significance, and ethical dilemmas physicians face on a daily basis. It has become pretty apparent to me that the fact humans function so well on a daily basis is a miracle. While it’s crazy to think we have learned all this in one semester, I knew I would be studying these subjects. This is medical school after all.

I knew we were complicated creatures, but I have witnessed another level of our awesomeness these past few weeks. Finals are not the most relaxed time for students. The elevated cortisol levels tend to bring out the worst in people. However, that has not really been the case for my class. It was clear from the beginning of school, that people were interested in collaborating. Classmates would share resources they were using, notes they had compiled, or Anki flash cards they had made with other classmates frequently. When classes ended and exams began, I assumed people would be MIA and only surface on exam days, like any other exam period I had experienced in undergraduate.

Since classes have ended, I have been blown away by the amount of generosity that has gone on. People sharing notes, resources, and uplifting videos in our Facebook group. I am constantly getting notifications about this new resource or PDFs or question banks or YouTube videos or outlined notes. While it’s hard to keep tract of what I could be using at times, but its comforting to know we are all working toward the same goals together. In addition to sharing resources, people have also been sharing their time. Classmates have made a concerted effort to check in with each other to see how

people are handling the stress of finals. It’s pretty amazing to see how invested people are in our success as a group, not just the individual.

I’ve been told going into medicine is like running a marathon. You cannot sprint, you have to pace yourself. Even though running and taking exams are individual sports, they are much easier when you have a team of individuals to help keep you honest with your training.  With four exams down and one more exam to go, there is an end in sight. We are about to cross our first finish line in a series of many races and I am incredibly grateful for the team I have here in Beer Sheva.

I mean, how hard can crossing the finish line be when you have people like this in your life?

"Finding Family in Friends," by MSIH December blogger of the month Tamara Kliot

Studying medicine abroad is exciting! There are always new places to explore, people to meet, languages to learn, cultural norms to adapt to, and things to discover. The opportunities to procrastinate studying for biochemistry or immunology are abundant. However, with the ending of classes and beginning of exams, there has been a noticeable shift in how people are allocating their time. Priorities are shifting as that list of important information to review continues to grow.

While having fun and taking “mini-vacations” are important stress relievers, it is easy to lose sight of that when you are in the thick of studying. It is easy to isolate yourself in a study fortress and spend your time surrounded by books and watching videos on metabolic processes. It is easy to forget to be a human and spend time with friends and talk to family.

I was reminded of this when my Israeli neighbor wished me a Happy Thanksgiving. He was the last person I expected to hear those words from, but he forced me to stop and think. Thanksgiving is my favorite holiday because it's an opportunity to spend time with family and reflect on the things we are grateful for. Living in Israel, it would have been easy to forget to celebrate or even acknowledge Thanksgiving. It is just another day in Israel and in many other countries for that matter. We had had a busy week, multiple quizzes to study for, and a paper to write; the last thing on people’s minds was Thanksgiving.

But as Thanksgiving continued, it was not just another day in Beer Sheva. Some of our classmates had the forethought to organize a dinner at Butchery to celebrate the end of first semester classes and well… Thanksgiving! It was a fabulous time with delicious food (tons of meat!) and amazing company. It was fun to see our non-American classmates get in the spirit of Thanksgiving as well! The night was filled with stories, laughs, and celebration (we did just finish one semester of classes!). I learned so many new things about the awesome people I am lucky enough to call classmates. It was a great way to recharge from a long week and reminded me that I do in fact have a family here in Beer Sheva, people I call friends and accomplices in this adventure we call medical school. 

"A Very Beer-Sheva Thanksgiving" by MSIH first year blogger Becca Siegel

On November 26th, 2015, several medical students from around the world celebrated Thanksgiving dinner in the Middle East. In Beer Sheva, Israel to to be exact.  I am pointing this out because it is notable in many respects. First off, the very fact that a group of people who regularly spend upwards of eight hours a day together would want to spend their few off hours together is quite amazing. Secondly, in a little city, in one of the smallest countries in the Middle East, students from all over the world sat together and had a meal because there was a lot to be thankful for.

We had just taken our last microbiology quiz of the semester. We were a few days away from our very last class of our first semester of medical school. We had survived. We had somehow managed to move to a brand new country, learn a brand new language and start medical school, all in one fell swoop.

Together we ate delicious food and we made nerdy jokes about mycobacteria and we toasted to a circle of people who could one day be called “doctor”.

Happy Thanksgiving from the class of 2019!!!

Now on to finals.

"Lost in Translation" by MSIH first year blogger Rebecca Siegel

A few days ago, when I was walking home for class, a man asked me for directions in Russian. I know that he was asking for directions, not because my Russian was sufficient to decipher his intention but because he was pointing to a tattered map. From what I could tell, he was looking to get to the post office, which was pretty much a straight.

I tried to communicate that it was straight ahead in every way I could. I attempted in Hebrew. I attempted in English. I made a line with my finger on his map. I mimed a person walking forward and finding a post office.

Nothing worked and with each attempt he looked progressively more frustrated. I also felt frustrated because I knew what he was going through and I was powerless to help. I too was a stranger in a strange place. I knew exactly what it was like to say the simplest thing over and over again and not see a look of understanding on the face of the person that I was talking to.

            To me, this is one of the greatest assets of going to medical school in a foreign country. The very fact that we know what it is like to struggle with being able to communicate and understand basic things is what is going to make us good doctors. Not understanding is hard.

            So here’s to my classmates who have known the true horror of taking a bite of a would-be-delicious breakfast parfait, only to find they had purchased sour cream and not yogurt at the grocery store.

My very resilient classmates who have double, triple and quadruple checked the bus map, only to find they were now farther from their destination then they started.

Together, we have learned intimately what it means to need help and lack the words to ask for it.

My peers and I represent a class of physicians who will understand that it is not the responsibility of a patient to communicate in ways a physician can understand. It is on the doctor to hear a patient’s explanation and figure it out.

"Clown College" by MSIH first year blogger Rebecca Siegel

           On Wednesday evening at 3:47, a typical first medical student rummages through her backpack, to prepare for her next class. She sits in the break room on the sixth floor of the internal medicine building at Soroka hospital. She takes out a biochemistry textbook and put it’s on the floor beside her backpack. She takes out some highlighters, flash cards, and a binder full of printed out slides from immunology lectures. She still hasn’t found what she is looking for. She pulls out a tutu and then continues to rummage until she finds a Santa hat.  “Finally”, she mumbles. It’s time for class. 

Welcome to medical clowning. Meet Dr. Amnon Raviv, the only self-proclaimed only personal in the world to have a PHD in medical clowning. He is a clown, a real-word superhero, and the instructor of this very special course. He is a human sigh-of-relief for people battling serious illnesses all of the country. On any given day he can be found in an oncology ward, belting out an upbeat western style song about colon cancer, or in the surgery wing, helping a 5-year-old boy make a list of what dreams he would like to have during surgery (before summoning in the anesthesiologist and reading the list of dream-demands aloud).

As we leave the class three hours later, I feel a little overwhelmed by how lucky we are to have Dr. Raviv. We are students of empathy and active listening. We are tutu clad care takers. And for three hours every week, we are allowed to reclaim some of the idealism that made us want to practice medicine in the first place.

       It’s time to practice. One student is the patient, one is the doctor and one is the clown. Dr. Raviv tells us that the patient is a small child who is getting a shot, but feels quite scared. The clown tries to make bird noises and funny faces in order to distract the child from the shot. Dr. Raviv stops the exercise.“ The child is afraid of the shot”, Raviv explains “and you’re not going to help by ignoring the shot.”   They try again, only this time the clown jokes about the shot. He pretends to give it to the nurse, to himself, even to the wall. “Better”, Dr. Raviv says. Slowly we are starting to understand.