As I was studying for the USMLE, I learned something interesting and this is a concept tested in the USMLE Step 1. You will also encounter a situation like this when practicing medicine since Americans love their unhealthy burgers and fries. As you know cholesterol cannot be broken down by the body like other molecules. Fats, carbohydrates, amino acids can all be burned by our bodies but cholesterol cannot and this is why cholesterol is a big health concern. Too much cholesterol in our bodies can lead to atherosclerosis which can lead to heart attack. So as I was studying, this system in getting rid of cholesterol is so interesting that I had to type it up from the top of my head and I know I will remember this for my long term memory because it’s so interesting.
Glucose from sugars such as carbohydrates converts to Acetyl CoA which then converts to Cholesterol and finally converts to Bile Acid. Bile acid is released from the liver to the intestines and it’s used to emulsify all the fat we consume for digestion in the intestines. However, bile acid is recycled back to the liver by albumin and so there is no reason for cholesterol to be essential. Too much cholesterol does not get used to make bile acid and it stays in the blood stream and it causes many problems such as atherosclerosis because cholesterol is not needed. So to help someone with cholesterol the individual is given Cholestyramine, which will bind with bile acid to be excreted out of the body and so the body will need floating cholesterol to create more bile. In order to create more bile it will pull cholesterol from the blood stream and make use of it which will lower the cholesterol concentration.
Another natural way to rid the body of cholesterol is eating a high fiber diet. So when your mom told you to eat your vegetables, she was telling you that for your own good. A high fiber diet also works in a similar fashion to wash out the cholesterol. However, one must do so before the cholesterol becomes plaque in the arteries of the heart, because after that happens then it’s not possible to reverse the problem without a risky open-heart surgery.
There are other methods to help individuals with high cholesterol level but it comes with side effects such as using statin drugs which inhibit HMG-CoA reductase which is the key enzyme in synthesizing cholesterol. However, HMG CoA reductase also creates Farnesyl PPi which is a key component in synthesizing CoQ enzyme. If you stop CoQ enzyme from synthesizing then you stop the Electron Transport Chain, which is a major pathway in the mitochondria. The liver and the muscles have a lot of mitochondria which works continuously in metabolism. To counteract the CoQ enzyme deficiency when using statin drugs, CoQ 10 supplement can be used to provide the body with the necessary CoQ enzyme.
I hope this post gave you an idea of how you will need to think after the 16 months in Bonaire. If you didn’t know don’t panic just take your time and study till you fully understand the concept.
There is a rumor that’s circulating in online forums which confused some students and also kind of freaked some students out. The rumor is that tuition is to be fully paid for two semesters all at before the AICM 5th semester is over. Let’s clear this thing out and please take my word for it since I am in the 5th semester now and I already got my tuition bill which is due in 2 weeks.
This is how it works; students plan to take 6 to 8 months off after 5th semester to study for the USMLE Step 1. The reason is for some students the AICM semester is too fast paced and students cannot keep up with the workload. So, what’s the solution? Study for several months to self-prepare for the test. Now Saint James School of Medicine now requires students to pass the NBME with a 650 or above and an the ExamMaster final test with a 75% or above in order to take the test. You cannot just register and take the USMLE Step 1 whenever you feel like it; you must be given permission from a medical institute to the ECFGM/NBME for you to take it.
This is how the billing works, ever since I started Saint James, which is in the year 2009, the billing policy, has been the same; you pay for the tuition a month before the next semester begins. Now let’s look at an example, if you were to finish AICM in the end of Summer semester, you pay tuition for the next semester, which is Fall semester, 30 days before AICM is done. After AICM you would have to sit down and study for 7 months, so that falls in 2 semesters after AICM. And therefore 30 days before each semester you would have to pay for the tuition. There are 3 semesters in a year: Spring, Summer, and Fall, and 30 days before each semester you would have to pay your tuition.
Now you may ask why you would have to pay if you’re not taking classes, I don’t know, it’s Saint James School of Medicine policy, but whatever you pay it counts towards your clinical semesters. Therefore, you’re not paying anything extra, you’re just paying ahead of schedule but it will count towards your clinical semesters.
I hope this helps out.
Look ma, I’m updating my blog. Yeah I know I haven’t updated anything for a while. The reason is I’m finally in the rotation part of AICM and it’s taking so much of my time. Some say it’s a waste of time but you actually see what illness people have and you learn a lot from it. I already got on-call rotation and it’s hectic.
In rotation no one will hold your hand. As in, you can do whatever you want go where ever you want and no one will keep an eye on you. However, you have to have certain papers signed by doctors and residents at the end of the week and turn it in to the administration. We also have topics to write about and present it to our preceptors. On top of rotations we have to do USMLE QBank questions and it’s just so much to do at once.
On my call I did history of a patient with few of my colleagues. We asked questions regarding their health, chief complaint, social history, family history, etc.
Right now, it really does not matter which school you went to. I’m working with students from ROSS University, American University of Antigua Medical School, International American University Medical School, and several more. The greatest part is we’re working with these students from other schools and yet we’re paying for rotations at a cheaper price than them; I guess that’s what makes Saint James School of Medicine stand out.
Also, I’m also lucky to see my old senior students from SJSM. They know me from Bonaire so they help me out; they all passed the USMLE Step 1 so they help me out of what I need to do and where I need to go.
So far, I’m enjoying the clinical setting and this is it. We are finally here minus taking the Step 1 which I will be taking soon. And when I do sit down and study for it hard core then this blog will not be updated for a long period. If you send me any email after April then don’t expect any replies until I’ve taken the Step 1, sorry but I have to do this.