Pediatrics Clerkship

This is a clerkship I was extremely excited about, because it was a field I was seriously considering going into! In fact, up until my third year Ob/Gyn rotation I was almost positive I would be a pediatrician some day. The clerkship was a lot of fun and definitely made my decision difficult, but as you already know Ob/Gyn ended up winning my heart…but not because Pedi let me down.

Pediatrics

This specialty is focused on children, there’s a lot of “normal” in pediatrics and you tend to get to know your patients and their families very well. The residency to become a general pediatrician is 3 years and you can specialize in any number of things, from neonatology to oncology, after you finish.

The Clerkship

  • 8 Weeks: One week is spent in specialty clinics, one week with neonatologists in the NICU, two are dedicated to inpatient pediatrics and the rest are spent in general pediatric clinic.
  • We had frequent morning lectures and case presentations by the residents to help prepare us for the NBME exam. These were *key* in doing well on this exam for me.
  • One overnight call while on the week of Neonatology.

Daily Life

  • Clinic Weeks: Basically 8am – 5pm.
  • Inpatient: Usually pre-round about 6am, round about 7am and spend the day admitting patients and making sure all is well with admitted patients. Checkout around 5:30pm.
  • Neonatology: Pre-round about 6:30am, round about 7:30am, and spend the day attending deliveries, taking care of procedures (lumbar punctures, circumcisions, etc.), and checking up on lab work/radiology for patients

Pediatrics Clerkship Books

        

  • At our school we have a wonderful physician who provided excellent clerkship notes that were key in doing well on the exam. I wish everyone had those notes.
  • Case Files Pediatrics: Easily the best-written book you can buy for preparing for the shelf exam. If you know this book well, you will score high on the shelf.
  • Blueprints Pediatrics: This book is decent if you need a text-book style, rather than case-style, book to read. I had it as a free hand-me-down and referenced occasionally, but I don’t know that I would have been very happy with it as a purchase if I had to pay for it. It was just ok.
  • First Aid for the Pediatrics Clerkship: Again I had this book as a hand-me-down and it was just okay. However, had I not had the notes from our clerkship coordinator, this & Blueprints may have been a tad more useful to me. I think we are spoiled on this rotation with great teaching.
  • The Shelf: This shelf exam is very age-oriented (whoda thunk it?). What I mean by that is knowing key things like what heart defect causes a “blue baby” immediately after birth and what heart defect causes a “blue baby” months after birth is what will help you do well on this shelf. A lot of the diseases have similar symptoms, but appear at different ages and this is key. Also, knowing basic milestones and developmental timelines will gain you easy points. I felt like it was heavy in infectious disease, cardiology, and respiratory.

What I Like

  • The Patientswell, most of them: I love kids and I loved that on this rotation I got work with kids all the time! They are so resilient and seeing them overcome things is really amazing.
  • Pediatricians: In general, this is a very upbeat, happy field. People tend to have great job satisfaction and be overall happy with their life as a pediatrician and it definitely shows in working with them. I loved the positive morale and environment.
  • Family-Friendliness: Pediatrics tends to be one of the areas of medicine that is relatively family friendly. Most of the residents have children and if they don’t already have them most want them some day.
  • The Hours: Compared to surgical specialties, the time-commitment of this specialty is a little bit better. Because pediatrics is heavily clinical, it offers a more consistent routine. Although, there are definitely rotations in pediatrics that are more intense.

What I Didn’t Like

  • The Patientsa few of them: I loved working with babies and toddlers and little kids, but the ins and outs of adolescent medicine made me feel like I was not cut out to be a pediatrician. I simply am not hard-wired to effectively discuss tobacco and alcohol use with a 13 year old. 
  • So. Much. Clinic: I like clinic in small doses, but Pediatrics involves so much clinic and very few procedures, no surgeries, and  a lot of chit-chat. 
  • Well-Child Checks: To be a good pediatrician I believe you truly have to be interested in normal development of children and, unless it’s the normal development of *my* children, it honestlyjust doesn’t fascinate me.
  • Lack Of Intellectual Interest: The subject important to pediatrics just don’t fascinate me like some other areas of medicine do.

Overall, I did really enjoy this clerkship. I loved most of the patients, the parents didn’t bother me, and the work was okay. Nothing about pediatrics really fascinated me the way reproduction and women’s health does and nothing caught my attention and heart the way reproductive endocrinology has, but pediatrics is a great field. The hours were tempting, the morale was attractive, and the people were great…but in the end it just wasn’t me. 

My Take On The Other Core Clerkships

 

Image Credit: imagerymajestic | FreeDigitalPhotos.net

Reflections on Third Year

The past year has been one of unexpected and broad personal discovery, involving aspects of heartbreaking disappointment and sheer, unsurpassable joy.

Since July of last year, when I started third year, I’ve met amazing people, learned incredible things (including learning how much I don’t know) and been afforded unique opportunities.

I can confidently say that the third year of medical school was one of the most life-changing years of my life. Not only did I (finally) figure out what I want to be when I grow up, but I experienced breathtaking highs, gut-wrenching lows, unexpected humor, and a back door glimpse into a mysterious side of life…and death…that many never see.

Overall, I feel like this year, both personally and professionally, I’ve truly experienced an overwhelming breadth of humanity…and honestly, I never saw it coming.

I just wanted to thank y’all for making this journey with me. I have received so much advice, support, encouragement, and love from Mind On Med readers and through Twitter. I am continually thankful that I choose to share my experiences here – not only to give others a glimpse into this life, but so I can look back someday and remember how pivotal these years were in helping me become the physician I will eventually be.

I’m expecting that the next year will be an adventure in itself – two new babies (!!) who will hopefully keep cooking until December (oh, did you miss that – yah we aren’t getting another dog – no my friend, we met our four-legged & furry quota long ago), residency applications and interviews, Match Day in March, and all kinds of fourth year fun (hopefully involving significantly more DIY projects than third year). Thanks for sticking with me through the craziness!

Ok, I do believe that is enough mushiness for one year.

Here’s a few of the most viewed posts on Mind On Med from the past year:

Image: FreeDigitalPhotos.net | Ambro

Surgery Clerkship

I finished up my Surgery Clerkship a while back and thought it was about time I gave you guys a peek into the daily life of a medical student rotating through surgery! I was a little terrified going in, but the residents all mostly turned out to be very down to earth (hard-working and busy, but down to earth) and helpful.

Surgery

A specialty that encompasses a variety of sub-specialties and involves a lot of…surgeries…who’d have guessed it? The residency for general surgery is usually five years and fellowships to specialize in other things are an additional 1 or more years after that. All in all – it’s takes a lot time to become a surgeon.

The Clerkship

  • 8 Weeks – Five weeks are split between the services covered in our hospital, including (but not limited to) trauma, vascular, general, burn (and burn ICU), SICU, etc. We also spent one week on a specialty (mine was Pediatric Surgery) and one week on Urology with the final half-week reserved for shelf-studying.
  • Occasional lectures, grand rounds, tumor boards and meetings.
  • Eight overnight calls – Basically arrive at the hospital around 5:30am as per usual and leave the next day around 8am or so.

Daily Life

  • Usually arrive around 5:30am or 6:00am and round on your patients, be ready for morning checkout by 7:00am.
  • Morning Checkout: Goes through all the patients admitted overnight and ensures all surgeries for the day are scheduled and covered by residents and attendings.
  • The rest of the day is reserved for surgeries, it’s really dependent on what service you’re on.
  • Typically home between 5pm and 8pm, depending on the service & how busy they are.
  • Occasionally you’ll go to clinic in the afternoon instead of scrubbing into surgeries.

Surgery Clerkship Books

    

  • Pestana Notes for Surgery – Easily the best and most used resource for this shelf exam, you can read about it here. Our school provided copies of it, so I’m not sure where to buy them.
  • NMS Surgery Casebook– Highly rated and easy to read, tons of relevant cases.
  • NMS Surgery Textbook – I didn’t use this, but heard positive things about it from people who wanted more text than just cases.
  • Surgical Recall – MUST HAVE for pocket book on this rotation! This book is so useful, even for other rotations. I guarantee it will have 85% of the pimp questions you receive on this rotation right there inside it. I used it to review relevant chapters before surgeries.
  • Overall  – This shelf exam is very Internal Medicine heavy, don’t just study surgery books! I made the mistake of sticking solely to Surgical books and while I still did okay, I think reviewing some internal medicine would’ve served me well.

What I Like

  • Working With My Hands: This field is centered greatly around the use of tactile skills. I liked that we were always doing something and getting immediate feedback on whether our interventions were successful or not.
  • Trauma Call: I did not expect to love trauma call, but it was so fun! There’s something exciting about being able to immediately solve an awful problem with your own two hands (and by “own two hands” I mean…other people’s hands…because let’s be honest, my hands don’t solve anything other than AgenesisOfTheCoffeeCup at this point).
  • Pediatric Surgery: This field was so fascinating to me. I saw an extremely skilled surgeon operate on a teeny, tiny 2 month old baby (who was born around 24 weeks). It was amazing. The whole week I was on Pedi Surg I was in love – it was great. However, in the end I knew it was not for me…mostly because I have no interest in doing 5 years of general surgery to maybe or maybe not get into one of the most competitive fellowships out there.

What I Dislike

  • Constantly Standing In One Place: Some surgeries are LONG – particularly some of the trauma surgeries and vascular surgeries – and standing in one place for 10 hour surgeries on a regular basis makes me wanna vomit. A couple days per week operating sounds great to me, but some of these surgeons are operating 5, 6, 7 days a week for 10 or 12 hrs a day. I just don’t have the stamina for that.
  • Variety: I can’t decide if there was too much variety or too little. All we did was operate – there was nothing else! There was tons of variety in that they possess the skills to do a huge number of different surgeries, but all they do is surgery!
  • No Pregnant Women: Unless it’s a dire emergency, general surgeons do not operate on pregnant women. I missed that patient population terribly.
  • Lack of Relationships: Except in very rare circumstances, these doctors are (rightly) not focused on getting to know their patients or developing long-term relationships with them. I missed getting to know my patients and having some continuity of care.
  • Often A Sad Specialty: A lot of surgeries end up with less than optimal outcomes, especially in trauma surgery. Most of the patients are very sick and many of them don’t make it. I missed having the occasional healthy or happy patient.

Overall, I enjoyed the rotation, but it was extremely exhausting and very emotionally taxing. The hours were long (often students were exceeding the intern hour restrictions) and the work was very different than what I want in my day-to-day life. While I enjoy utilizing my tactile skills (or, developing them, rather), I don’t want surgery to be the sole focus of my career. I really enjoy being a part of a patient’s care long-term and getting to know them a bit better and I’d miss that if I were to decide to go into this specialty.

Information on Other Clerkships!

 

 

Image: FreeDigitalPhotos.net | jannoon028

Ob/Gyn Clerkship

I finished up my Ob/Gyn rotation at the end of December, right before we headed out for our awesome New Zealand adventure, and never got around to telling y’all about it…so here we go!

Obstetrics & Gynecology

This is a specialty that deals solely with all the amazing (and occasionally scary and not-so-amazing) things the female reproductive tract can do.

Obstetrics is derived from the latin word “obstare” which means “to stand by.” Obstetricians take care of women who are pregnant, trying to become pregnant, in the process of becoming un-pregnant or who have recently given birth. It’s a unique field in that it requires the physician take care of two patients who are literally joined together for a time.

Gynecology is the counterpart of the field of obstetrics and deals with normal physiology, as well as disease, of the female reproductive tract. It involves everything from surgery to clinical preventative care and encompasses a large array of normal and abnormal medicine.

The Clerkship

  • 8 Weeks: Rotations on Labor & Delivery, Night Float, Outpatient Obstetrics, Reproductive Endocrinology, Inpatient Gynecology, Outpatient Gynecology and Gynecological Oncology
  • Occasional lectures, practice clinical exams on Fridays
  • Night Float: A week on the L&D floor at night, 5:30pm – 7:30am. Includes attending births and delivering multiparous patients, as well as triaging patients who come in with obstetrical issues
  • Labor & Delivery: Basically identical to night float, but in the day-time hours
  • Outpatient: Straightforward obstetrics and gynecology clinics, including some time in ultrasound, high-risk Ob & general clinics
  • Reproductive Endocrinology: A field I enjoy immensely, helping women with fertility issues achieve & sustain pregnancy
  • Gynecological Oncology: Diagnosis & treatment of cancers of the female reproductive tract
  • Inpatient Gynecology: Benign surgical gynecology

Daily Life

  • Varies greatly depending on what week of the rotation we were on. Outpatient clinic is generally 8am – 5pm, while surgical specialties tended to have longer hours and Labor & Delivery/Night Float is a pretty set 12-ish hour day.

Ob/Gyn Clerkship Books

        

What I Like

  • The Patients: By & large the population in this field is young, healthy patients getting routine care…there are exceptions, but the “bread and butter” of Ob/Gyn is the young, healthy woman.
  • The Field: I don’t know why it didn’t strike me until I was in the midst of this rotation, but this area of medicine has always been my favorite intellectually. Studying for this rotation wasn’t studying for me, it was interesting. In anatomy pelvis & perineum was my best (and favorite) section, reproductive physiology was by far my favorite…and reproductive endocrinology could hold my attention for hours. I just find it interesting & exciting.
  • Variety: A little bit of clinic, a little bit of surgery, a little bit of boredom and a little bit of adrenaline…all around fun!
  • Happiness: Sure, when things are bad in Obstetrics they are really bad and usually involve a lot of sadness. However, this is one of the only fields of medicine that deals extensively with happiness. People are never excited to be in the hospital, but if they get to leave with a baby it definitely offers some consolation…much happier than being admitted for a ruptured aortic aneurysm or acute kidney failure or alcoholic liver cirrhosis.
  • Surgery: I thought I would hate everything about surgery…when I didn’t it threw me for a loop. Until this rotation I would say I was about 90% sure I was going into Pediatrics, because I seriously thought I would hate being in the OR. Now, I’m not sure.
  • Active: This field is a lot about doing – even in clinic. You’re always doing something, which helps keep me focused and maintain my attention…pap smears, biopsies, surgeries, deliveries, ultrasounds, etc. Lots of activity in Ob/Gyn.

What I Dislike

  • Family Friendliness: It’s no secret that surgical fields are less family friendly than non-surgical fields. However, this is rapidly changing with each graduating class of new physicians. I experienced no negativity towards women in Ob/Gyn who have a family, but it wasn’t as overtly supportive as some of the other rotations have been.
  • Hours: Unpredictable hours can be frustrating for planning the rest of your life.

Going into this rotation I knew I would love the Obstetrics part, I have a real interest in all things reproductive (hardy har, keep the jokes to yourself…this blog is family friendly…usually) and thus knew I would seriously enjoy the part of the rotation that dealt with Ob. So, why did I never really consider this a career option for myself? I figured I would hate the Gynecology & surgery part of it.

And…when I didn’t it threw a loop in my life plans. Now I’m not sure what I want to do with my life…

It’s like I can hear the time ticking away…things I need to get done that aren’t getting done…letters of recommendation, away rotations, personal statements. AH!

But, like my mom told me the other day – I guess it’s better to like two areas & not be able to choose one than to go through all of this and hate everything.

Psychiatry

Psychiatry Clerkship

PsychiatryI finished my Psychiatry Rotation a couple of weeks ago and figured now would be a good time to recap the Freudian experience.

Psychiatry

Psychiatry is a specialty that deals with diagnosing and treating mental disorders. The difference between a Psychiatrist and Psychologist is in both training and job description – Psychiatrists have medical degrees (either MD or DO) and the prescribing abilities consistent with such. Psychologists typically have a PhD and do not prescribe medications. Their job descriptions are similar, but not identical and also not a subject I’m prepared to tackle. If I have any Psychiatrist/Psychologist readers who’d like to guest post on this, I’d love to have you!

The Clerkship

  • 8 Weeks: Four on the Inpatient Unit and four in the Outpatient Clinic
  • Occasional lectures, much fewer than Internal Medicine
  • Night Float: Basically overnight call lasting from 4:30pm to 7:00am for a total of 3 days
  • Weekend Call: One weekend of being on-call to see consult patients
  • Consult Week: Five days during the outpatient portion dedicated to seeing patients who are in the hospital for a general medical condition and need care for a comorbid psychiatric issue
  • Child Psychiatry: Five days during outpatient dedicated to seeing pediatric psychiatry patients

Daily Life

Outpatient Clinic: Typically an 8am – 5pm layout consisting of seeing scheduled patients in a clinic-setting. We were responsible for bringing the patients back, getting their vital signs and talking to them about what was going on. After speaking with them we would observe the Resident and Attending assessing them and coming up with a treatment and follow-up plan. We were responsible for writing out notes for several new patients to be graded by one of our attending physicians.

Inpatient Clinic: Inpatient days start at 7am with checking in on our 2-3 patients from the previous day. We find out about things like medication side effects, appetite, mood and sleep. At 9am we have group staffing with all the doctors (residents and attendings), nurses, counselors/therapists, etc. who work in the unit. After staffing we see the patients assigned to our resident individually with both the resident and attending present and come up with a treatment plan and course of action.

Psychiatry Clerkship Books

What I Like

  • Time With Patients: Psychiatry is all about talking to your patients. There was never a time on the rotation that I felt rushed through a patient interview and it was awesome. I wish all specialties had the luxury of unrushed patient interviews.
  • The Lifestyle: I’d be lying if I said I didn’t enjoy the hours of Psychiatry. While there were days I was on call at night or throughout the day, it was noticeably different than Internal Medicine. The hours are really nice and the attitude is typically laid back.
  • The People: Almost every person I worked with in Psychiatry was extremely amicable and enjoyable to be around – this includes the patients, doctors, nurses and other staff.
  • Interesting Cases: The types of things you see in Psychiatry are unlike anything else. It’s equal parts amazing and interesting to see the types of things the mind can do, both good and bad, and to encounter the types of illnesses I’ve read about since my first year of college (my undergrad degree is in Psychology).

What I Dislike

  • Small Scope: While it’s goes without saying, the scope of Psychiatry is quite limited. I used very little of what I’ve learned over the past 2 years and, while the specialty was definitely challenging, I found it less intellectually stimulating than other areas of medicine.
  • It’s Slow: Psychiatry is less hands on than other areas of medicine and I found it a bit slow. While I absolutely love talking to my patients, I also enjoy active and hands-on medical care. I didn’t do a single physical exam the entire 8 weeks.
  • It Broke My Heart: Not just the illnesses, but the stories I heard. In those long patient interviews I learned about the resilience of the human race, but I also learned about some of the horrible things the people around us go through – physical abuse, sexual abuse, abandonment, mistreatment – it simply hurt my heart to hear these stories every day. I wanted to hug my patients and cry with them and there were many days I went home extremely disappointed in the way we humans sometimes treat each other.
  • Emotionally Taxing: Along the same lines, the daily life of a Psychiatrist can be extremely emotionally exhausting. The hours may be fabulous, but you often go home incredibly exhausted from the emotional requirements of the job.
  • Something’s Missing: Like Internal Medicine, I just felt like something was missing in this rotation. I wasn’t using the skills and knowledge I want to use and while I have great respect for everyone in Psychiatry, because Lord knows we need people who love this specialty, I don’t know that it’s for me. I want to use my physical skills and general medical knowledge a bit more than I was able to on this rotation. Again, I didn’t dread my days in any way, shape or form, but I also didn’t get excited for the day to start on any occasion during this 8 weeks.

Stop! Or I’ll…Dump Water On Your Head

A psychiatrist I was working with was recently talking to some families about the importance of following through with so-called “parenting-threats” you make to a child. As I listened in I thought how difficult it must be to consistently do that, especially if following through with the consequence adds an element of stress or difficulty to your situation. A quick interrogation of the Google machine turned up hundreds, if not thousands, of relevant blog posts and articles to confirm my suspicions that this was no easy feat.

Be Careful What You Say

Today I was considering that conversation and came to the conclusion that if anyone in my marriage would eventually have trouble with this, it would be my laid back and quiet husband, not me (because I’m so perfect and all). I’m the type of person who tends to be more over-bearing, outspoken and “in charge” (typically only in my own mind am I honestly in control of anything).

He’s the type of person that doesn’t say a whole lot. But, that means when he does decide to talk – you listen – because it’s either hilarious, important or absolutely ingenius (or occasionally borderline insane).

I remembered an incident from when we first started dating and realized my assessment of which of us was better at following through was apparently starkly inaccurate.

————————————–

  It was Spring of 2007, we’d known each other less than a year and were cooking dinner at his house one evening. I was in an ornery mood and doing something that I’m sure was purposefully annoying and painfully asinine in the name of flirting.

As I tapped and poked him in the ribs over and over, not unlike a four year old I watched in clinic trying to provoke a reaction out of his mother, Donnie said to me,

 

“If you do that again I will pour this entire bottle of water on your head.”

 

I thought,

“There is no way he will do that. We’re in his kitchen and it would make a huge mess and it would probably make me mad. I’m his new girlfriend…nobody wants their new girlfriend mad. He totally wouldn’t do that.

So…I poked him again…right in the ribs. And…

He poured bottled water over my head…right there in the middle of his kitchen.

 

Right there in front of God and everyone (and by everyone I mean Aubrey, his Zambian roommate who ended up as the best man in our wedding) my boyfriend dumped 12 ounces of bottled water onto my freshly-straightened hair and stared at me with an I-warned-you-you-dummy look on his face as spring water some kid in the Andes meticulously bottled by hand (what, you mean your water doesn’t come hand-bottled from the mountains? weak sauce.) dripped down my previously dry t-shirt, rolled down my legs and splatted onto the tile floor of his rent-house.

As I stood, soaking wet, in a puddle in the middle of his kitchen I never thought that incident would come back to me in 6 years as an indicator of how trustworthy he is.

 

And, I can tell you one thing, now when he tells me…

“Stop or I’ll…”

…I stop.

 

Usually.

 

It may seem silly or trivial, but it’s true – when people follow through on their word, even on things that are seemingly pointless (or even mean! like dumping water on your girlfriends freshly straightened hair), it builds trust.

Do you have trouble following through? Do you think this is an important aspect of gaining trust in relationships? Parents, how hard is it to consistently follow through with your kids?

Image: photostock / FreeDigitalPhotos.net

Image: Paul | FreeDigitalPhotos.net

Team Discussion

Internal Medicine Clerkship

I started my Internal Medicine clerkship in July and my shelf exam will be on August 25th. Since I’m just over half-way done I figured it would be a good time to do a recap of the past few weeks.

Don't Put Hospital Pens In Your Mouth
image c/o of photostock

Internal Medicine

Internal Medicine is a specialty that primarily deals with diseases in adults. As our clerkship director put it, I-Med is basically everything minus pregnancy, kids and surgery. It’s a very broad specialty and not unlike family medicine in some ways, but quite different in that it specifically excludes obstetrics and pediatrics.

The Clerkship

  • 8 weeks – 6 on inpatient, 1 in clinic, 1 with an IM subspecialty (mine was Heme/Onc)
  • “Teams” consist of 1-2 medical students, an intern, resident and an attending.
  • Daily lectures, weekly “Grand Rounds” lunch meetings and various additional conferences
  • “Q4” Call, which means we’re on call every fourth day. Call for this rotation is 7am – 9pm and you’re required to be at the hospital that entire time, unless your resident tells you to go home. It’s a lot of call days, but we don’t have overnight call for this clerkship, so it’s not bad at all.

Daily Life

What time you get to the hospital and what time you leave highly depends on how your team operates, what your patient load is, how complicated your cases are and when your scheduled conferences/lectures fall in. This week we had one hour lectures at 7am and my team was rounding (this means discussing & seeing all the patients on our service as a full team) at 9am, so I didn’t have to be at the hospital until 6:40am or so to print out patient info, go to lecture at 7:00am and then see my patients. Some days we leave at 2pm or 3pm and some days we leave at 6pm or 7pm. On call days we leave at 9pm. It’s very random and different each day.

Twitter Questions

  • “How little sleep do you actually get?” I probably sleep about 6 hours per night, but I could honestly sleep more than that if I would be more disciplined about bed times.
  • “How much do you study now?” Not enough. This shelf exam is notoriously hard, so I should be studying more than I am, but it’s hard to come home and concentrate when you’ve been running around all day.
  • “What do you actually do?” Talk to patients, practice writing notes, pretend I can come up with diagnoses and treatment plans (they’re basically always wrong), practice history-taking and physical exam skills, help out the residents with paper work and other random stuff that makes their day a little easier, incorrectly answer questions my attending asks, fumble with BP cuffs despite knowing exactly how to take a blood pressure and doing it 10 times a day for the year I worked as an allergy tech, basically walk around looking and sounding goofy and out of place.
  • “What’s the scariest thing you’ve had to do on your own?” I really haven’t had to do anything scary on my own! My school did a great job preparing us to be third years by giving us ample opportunity for clinical experience during the first two. In this rotation we don’t do a lot of procedures, so it’s been pretty much without fear so far. I’ve gotten to assist with central line placements and bone marrow biopsies, though – that was lots of fun even though my job was pretty much limited to opening packages and tying sterile gowns.
  • “What books are you using?” Ah, good question.

Medicine Clerkship Books

  • Step-Up to Medicine: This is by far the most recommended book for this rotation. It’s a great overview, written in bullet-format (similar to First Aid). It’s a good review.
  • First Exposure Hospital Medicine: Our clerkship director issued copies of this book and the one below. They are pretty good – short chapters, quick overview and easy to read, but not enough a solo-resource for the shelf exam.
  • First Exposure Ambulatory Medicine: We had a quiz over this at the end of our clinic week. It’s a good, easy-to-read book, but like the other it’s probably not efficient enough for the shelf.
  • MKSAP For Students: I don’t actually own this one, but it comes highly recommended from a few 4th years. There’s a copy in our I-Med office, so maybe I’ll give it a looksy next week.
  • USMLE World Step 2 CK Q-Bank: There are over 1400 questions in Q-Bank that cover Internal Medicine. We just got access to Q-Bank on August 1st, so I havent used it much, but I think it will be helpful. The questions seem pretty tough.

What I Like

  • Instant Gratification: Inpatient allows for longitudinal care of hospitalized patients, so you get to see first-hand how treatments are helping (or not) over the course of a few days.
  • It’s Busy: There is always something to be done. I’d much rather be running around, busy and exhausted, than sitting around bored with nothing to do.
  • Skill: There’s a lot of diagnostic skill and brain power necessary for Internal Medicine. They are kind of like the physician investigators of the hospital…if someone isn’t sure what’s going on, they call the Medicine team. So far I’ve felt like every resident & attending I’ve been with has been a great diagnostician.
  • Complexity: Along those same lines there is a lot of variety and complexity in this field. It’s interesting to see people use little pieces from literally every part of their education – from Biochemistry to Fellowship training.
  • Opportunity: There are tons of fellowship opportunities in Internal Medicine – Cardio, Endocrine, Hematology, Oncology, GI, Infectious Disease, Pulmonology, Rheumatology, Nephrology and more. I absolutely loved my specialty week with the Heme/Onc team.
  • The People: I’ve really enjoyed the patients, house staff and physicians on this rotation.
Newborn
image c/o of arztsamui

What I Dislike

  • Something’s Missing: Kiddos. I really enjoy working with kids and Internal Medicine specifically excludes them.
  • Something Else Is Missing: While I’m getting to where I truly am enjoying this rotation (the first few weeks were rough), I don’t have that “feeling” people talk about getting when you’re doing what you should choose as your specialty. Internal Medicine doesn’t make me incredibly excited and I don’t feel like it’s something I’d be amazing at, but I also don’t hate it (anymore, like I said – first few weeks were rough…I think that was more the process of getting my role as a 3rd year nailed down). Who knows, though? I absolutely do not dread my days at all and I definitely enjoy what I’m doing most of the time. I just don’t know if this is “it,” so to say. Although, I seriously fell in love with Hematology/Oncology, so maybe it is.