Arc of the Sun

Eight hours is a pretty solid work day for most people, but Jennie Yoost, M.D., can only smile at the thought. As a medical student at the University of Louisville for the past four years, she's accustomed to working much longer days just to squeeze everything in.

Medical school is like that, Yoost says.

"The first two years are probably the hardest, because you're in class all day and studying all night. There's just so much information to absorb that you're in a constant state of learning.

"Sometimes it can be hard to see the light at the end of the tunnel, but that's what makes the third and fourth years of medical school so rewarding. When you begin those clinical rotations, you can put into practice what you've worked so hard to learn during the first two years."

Even then, however, the educational opportunities never cease.

"There's always something new to learn and experience," the Frankfort, Ky., native says. "Students are constantly exposed to an excellent variety of interesting cases while working in the hospitals here, and there are numerous specialties to explore in as much depth as you want."

Yoost, who graduated from the School of Medicine on May 14 and just began a residency in OB/GYN at the Medical College of South Carolina, looks back on her experience at UofL with a tremendous sense of satisfaction.

"It has been a challenging process, but I worked with a lot of great teachers and outstanding physicians who were ready to share their knowledge in a supportive environment. I think UofL has given me an excellent foundation on which to build the rest of my medical career."

6:30 a.m.: Yoost's day began a half-hour earlier with a cup of coffee, a brief shower and a quick bite to eat. At 6:30, Yoost leaves the apartment she shares with her husband, Tim, another fourth-year medical student, and commutes 20 minutes to University Hospital.

Jennie says it has been a mixed blessing for both she and Tim to be in medical school at the same time. It made studying easier when coursework overlapped, for example, and they both had an intimate understanding of the pressures each spouse faced. But "away rotations," when students travel to distant hospitals for clinical training, meant the Yoosts went months without seeing each other.

6:50 a.m.: Yoost arrives at University Hospital and reports to the surgical service. She is in the second week of her perioperative rotation will gain hands-on experience preparing patients for surgery and anesthesia today.

7:15 a.m.: Yoost and two other fourth-year students, Victoria Shively-Graham and Mark Moore, meet with Kris Marshall, M.D., to discuss the day's cases. Each student is assigned a patient to work up prior to surgery.

7:30 a.m. - 7:45 a.m.: Yoost takes a patient's history, conducts a basic medical exam and answers his questions about the day's procedure.

7:50 a.m.: Yoost joins first-year medical students Joseph Mittel and Theodore Gerstle as they prepare to observe operating room procedures with Heidi Koenig, M.D., an associate professor of neuroanesthesiology.

"We incorporate a lot of anatomy, physiology and pharmacology instruction in this experience, because the OR is such a great place to demonstrate their interdependent relationships," Koenig says.

8:00 a.m. - 8:20 a.m.: Koenig instructs Yoost on the proper insertion of a central venous line, which will administer medications to the patient during surgery.

8:30 a.m. - 9:30 a.m.: Yoost begins her OR activity by administering general anesthesia to a patient under the watchful eye of Beth Adkins, a registered nurse anesthetist.

9:35 a.m. - 10:35 a.m.: Yoost then moves to another operating room to help anesthetize a patient undergoing a tracheotomy. "I'll be doing a lot of surgery as an OB/GYN, so this is excellent training," Yoost says.

10:40 a.m. - 11:00 a.m.: Yoost joins other medical students for a conference with Koenig. They discuss the day's cases, the relative merits of various anesthesia medications and cost-management considerations.

11:05 a.m. - 12:30 p.m.: Yoost examines patient charts and conducts post-operative pain-management rounds with Laura Clark, M.D. Today's cases include the victim of a car crash and a patient with chronic pain who is learning to use catheters that deliver nerve-signal-blocking drugs.

1:00 p.m. - 2:00 p.m.: After a brief pause for lunch, Yoost will spend the next hour in a classroom setting discussing a wide variety of anesthesiology medications.

Mark Glasgow, M.D., had asked each student to research a drug used in the practice of anesthesiology, and the students are presenting their findings today.

2:00 p.m. - 3:00 p.m.: Classroom instruction is followed by an hourlong session in the School of Medicine's patient simulation center. The state-of-the-art facility features computer-controlled mannequins that realistically mimic real patients based on pre-programmed scenarios.

Today's "patient" is a 55-year-old woman with hypertension, hyperthyroidism and a history of smoking. She'll be undergoing a breast biopsy and will require general anesthesia.

"The simulation center is pretty awesome," Yoost says. "It gives you the opportunity to learn in a safe, risk-free environment."

3:30 p.m. - 5:30 p.m.: As the day draws near an end, Yoost finds time to pay a little back. She joins a student-staffed panel discussion called "After the Match," which is designed to help second- and third-year medical students plan for and attain the most suitable residencies upon graduation.

More than 30 people attend the main session to hear advice from Yoost and other fourth-year students, including Jennie's husband.

5:30 p.m. - 7:15 p.m.: Jennie and Tim drive home for a rare bit of quality time -- dinner together -- but Jennie must return to campus by 7:30 to tutor a first-year medical student in the basic sciences.

7:30 p.m. - 9:30 p.m.: The study session in Kornhauser Library lasts two hours, so the sun has already set by the time Jennie leaves to return home and grab some sleep.

Another productive day has ended in twilight, but tomorrow will come soon enough, and it will bring even more opportunities to learn about the healing art of medicine.

"I find it really rewarding to help people in their time of need," Yoost says. "That's one of the reasons I went into OB/GYN. Giving birth is such an important part of a woman's life and a wonderful experience to share. I absolutely love what I'm doing."