First Few Days of Internal Medicine

3 days down, hundreds of day to go left of third year!

It has been quite the crazy last few days. From having my first clerkship orientation, to learning everything I would ever want to know in a 2-day 8 hour ECG work-shop, to having my first patients, to learning to navigate the EMR, and to finding out my score of just a little thing called Step 1 (but I'll get to that later).

Day 1: Monday morning, I went to Sparrow Hospital at 8 AM (which seems so late in the day now). We met with our incredibly nice clerkship coordinators in the morning to go over 1) the clerkship calendar, 2) all of the requirements, 3) how to honor, and many more important topics. It was amazingly informative. After the orientation, our little group of 5 students on the Medicine clerkship had 5:2 attention during a 5-hour ECG workshop (part 1) with two amazing Internal Medicine docs. They used the socratic method and basically put up and ECG, called us up to the overhead and made us interpret them even though we had absolutely no idea what was going on. Eventually, however, ECGs became (dare I say it) fairly easy to read and I know feel (somewhat) confident in how to interpret them! Who would have guessed? After the ECG workshop, we got a quick introduction to all of the different cases and logs we would have to complete on various websites and then got to have the rest of the afternoon to start reading and register for all of the millions of websites and research tools we needed to register for.

Day 2: Our first day with patients!!!! Gahh...I was so nervous. I went up to the 8th floor of Sparrow Hospital at about 7:10 AM. We were supposed to be there by 7:15 for morning report (where the night shift docs hand off the patients in a very systematic way to the daytime docs). I didn't really know what was going on for the first hand-off, but I think I did a good job pretending by jotting down notes in the margins of our patient list. After hand-off, the resident looked at me and told me to "go see the patient in room ***." And that was it...no shadowing, no introductory patient... I was just told to go see the patient and report back when it was time to round with the attending. I spent 1.5 hours with my first patient. I know, I know this sounds like an ABSURDLY long time to spend with one patient...but I am not efficient yet and I don't know whats important, so I pretty much got this guy's life story, which was quite fascinating. After doing a history and physical exam on my patient, I headed back to the resident room, checked some of his info on the EMR, went to meet with the attending, and gave my first real oral presentation (talk about nervous!!!). Much to my surprise, the oral presentation went really well! After all of the patients had been discussed and we had come up with plans for each of the patients, we rounded as a team to each of the patients' rooms with the attending physician to further speak with the patients. It was a really amazing first day of rounding and I learned a TON. I thought I was going to absolutely hate internal medicine, but I've loved it so far! After rounding, we headed back to a lecture room and finished our last few hours of ECG work-shop (part 2).

Day 3: Today was crazy fast-paced. I got in a little earlier (6:55ish) to look up my patients, but quickly ran out of time. By the time morning report and a quick resident-given lecture about acute COPD exacerbation was complete, it was 9 AM and I had only 30 minutes to round on 3 patients! 3! This time yesterday, I spent 1.5 hours on 1 patient! So, obviously I freaked out and didn't do well, but hey I guess its my second day and its not that big of a deal. I have learned my lesson and will show up earlier tomorrow! After a morning of rounding, we headed again to a lecture; this time it was split into a Q&A session (basically answering board-type questions in my little group of 5) and 30 min mini-lecture on anemias. Overall, it was a pretty good day, but I know that I need to get my s*#& together when it comes to rounding on my patients earlier/quicker/more efficiently, but I think that will come with time.

Oh...and something else that happened today...................I FINALLY got my Step 1 score. You know, Step 1..The exam that I spent a month intensively studying for. The exam that determines where/when I can do residency. Yeah, that exam thats kind of a big deal. We were told that the exam scores would be released to MSU early this morning. If we had failed, the school was going to page us to come in and talk about when we could retake the exam/whether or not we had to stop the current clerkship we were on. If we didn't receive a call, our exam scores would be released via email by 11 AM. So, I had to use all of my self control not to frantically check my email/text messaging every 6 seconds. Thank goodness that I had a busy morning, otherwise I think I would have gone crazy. Well, all morning I waited and waited...convinced that I would get a page. Finally, a little after 11 AM I got a text from a friend to tell me scores were up. I took that as I sign that I had passed and let out a HUGGGEEE sigh of relief. I decided a while ago that I didn't want to check my score for a while, but with EVERYONE around me telling me to check it, I finally gave in at around 4 PM. I made my friend Michelle stand with me while I opened it, because I was so terrified that I would burst into tears. So, after a few seconds of calming myself down, I pushed "view results" and closed my eyes. When I finally mustered up enough courage, I opened my eyes and *sigh* I could finally breathe! I was so so happy with my score. It wasn't the highest score I had gotten on a practice test, but it was close. Its a score that puts me significantly above average for most medical specialties, especially those that I am actually interested in. Its a score that puts me in a position that (according to the latest residency charting outcomes) "almost always grants an interview" at the majority of residency programs. So, yes. I did it! Such a relief. Good riddens, Step 1! I'm so glad that is officially over with!