2011-2012: The Year in Clinicals

Posted on August 8, 2012

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I’m going to start bringing this to work.

It’s easy to get caught up in the tests and scutwork that dominate the third and fourth years of medical school.  Students are eager to get out of the classroom and into the hospital full-time, but that enthusiasm often fades with each fax, copy, or phone call that must be placed, and can turn to downright resentment when it comes time to complete a rotation in a specialty we’re not at all interested in.

Although I enjoy complaining as much as the next guy, I did try to keep an open mind through all of my rotations, especially since I do desire to be a well-rounded physician, but also because some of these experiences may be my last exposure to a particular field for the remainder of my career.

The idea for this post came to me around the time of the new year – I tend not to make resolutions, rather, I prefer to reflect on the year and what I’ve learned from my experiences.  Last May, I began full-time clinical duties, with clerkships across various specialties from surgery to radiology.

I’ve had far too many experiences to reflect on individually, but I think I’ve been able to learn an important lesson during each clerkship.  What follows is a summary of the things I hope contribute to my being a better doctor.

Surgery (May 16 – July 8, 2011):  Volunteer before you’re volun-told.  There are some things that no one will want to do, for whatever reason (because it’s gross, a waste of time, ‘below’ your skillset/training, etc.).  In the hospital, it’s everyone’s job to take care of the patient – just make sure it gets done.  [Advice]

Radiology (July 11 – Aug 6, 2011) Always, ALWAYS read your own films – I cringe when I see someone simply open and close a radiology report before talking with a patient.  Also, working in an air-conditioned room is nice.

Neurology (Aug 8 – Sep 2, 2011):   Don’t rely on someone else’s physical exam.  Neurologists are second only to pediatricians in the category of “Worst Ties” – but I love it.

Internal Medicine (Sep 6 – Oct 28, 2011):  This is where you’ll really solidify your knowledge of pathophysiology, the physical exam, and basic treatments for the most commonly-encountered diseases (and occasionally, a few rare ones).  More importantly, you’ll also have more time to read, teach your patients, and develop your bedside manner.  Regardless of what you think you’ll go into, don’t slack on this rotation.  [Advice]

Psychiatry (Oct 31 – Dec 9, 2011) As is true with handling animals, you can’t expect a person to behave without first assuring them that they’re safe.  (Also, it seems that psychiatrists tend to make everything up as they go along – sorry, guys.)

Family Medicine (Dec 12 – Jan 27, 2011):  Being “healthy” does not mean you’re completely free from little annoyances that come with the territory of owning & operating a human body.  Many of my patients would have been wise to heed the advice of singer Dallas Green – “You need not to find a cure / For everything that makes you weak”

Obstetrics/Gynecology (Jan 30 – Mar 9, 2012) This is the one specialty where it’s entirely possible – nay, likely – that you’ll get every type of bodily fluid on you within a 60-second time span.  Also, don’t wear cologne around pregnant women.

Pediatrics (Mar 12 – April 20, 2012):  No one enjoys being jolted awake by a cranky stranger with coffee breath at 6AM, but 3 year-old children especially do not like this (even when you offer them a Bob the Builder sticker).  And for some reason, pediatricians seem to have something against sleeves.

Just an observation…

Hematology/Oncology (Jun 10 – Jul 7, 2012):  We have more information about cancers than we know what to do with, and that’s still not enough.

Internal Medicine, sub-internship (Jul 9 – Aug 3, 2012):  Speak up, and get involved – you might alter the course of a patient’s treatment in ways you never imagined you could.  This is your time to play Devil’s Advocate.

Gastroenterology (Aug 6 – Aug 31, 2012):  Convince someone you love to get their colonoscopy.  Also, your mother was right about chewing your corn well.

So as you make your way through the various wards and outpatient clinics of your final years of training, my advice is this:  take it all in.  Even if you have decided you’ll be your generations preeminent cardiothoracic surgeon, don’t be in such a rush to get where you’re going.

Your patients will thank you.

“The struggle itself toward the heights is enough to fill a man’s heart. One must imagine Sisyphus happy.”

-Albert Camus

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Posted in: Humor, Medicine