Summer Externship

I spent my last 4 weeks of the summer volunteering at the St. Johns Hospital & Medical Students, in a summer program for first year medical students. We each got to pick one specialty per week that we would like to work. Since I chose to do 4 weeks, I got 4 specialties. My first two picks were fairly easy, because they were the two specialities I was most interested in: Pediatrics and OB/GYN. The second two weeks I decided to try specialties that would allow me to see/do the most I could in a week. These selections ended up being Emergency Medicine and General Surgery.

Week 1: Pediatrics

I always knew that I would love the field of Pediatrics. Out of almost every field of medicine that I have shadowed, I always enjoyed working with the babies or young children more than any of the adult patients. So, needless to say, I was thrilled to be spending a week on Pediatrics. This week, I got to try out a whole bunch of different subspecialties. These subfields included: General pediatrics, In-patient pediatrics, Peds GI, Peds Nephrology, Peds Allergy/Imunology, Peds Hematology/Onccology and Neonatology. Overall, I had a really great week. However, I also had some moments of clarity on what I would want/wouldn't want in my future profession.

First, I want to say that I absolutely loved the patients! Kids are just so dang entertaining. However, I figured out that I don't really love working in the clinic all the time. Some days would be ok. but if my entire medical career was centered on clinic work, I think I would go nuts. In fact, my favorite days were working in critical care, especially in the NICU.

Positives: the patients and my love for children
Negatives: wayyyy too much clinic time.

Week 2: Emergency Medicine

After realizing I didn't love clinic during the first week, I was really excited to try out Emergency Medicine. The ER that I worked in is right on the border or Grosse Pointe (a very nice neighborhood) and Detroit (one of the poorest cities in America). So, I prepared myself to see quite a diverse amount of cases...and boy did I! The ER is sure not short on its excitement. From gun shot wounds, to Congestive Heart Failure, to car accident traumas, to foreign body obstructions (ex: kids sticking beads up their nose)....you truly don't know what you are going to get one minute from the next.

Positives: Excitement, diversity of cases, shift-work/no call
Negatives: Never really get to see a case to its end, very little time actually spent with the individual patients, and a lot of distrust in patients (because many people come to the ER for drug seeking)

Week 3: OB/GYN

This week, I got to spend 1/2 the time on OB and 1/2 the time on GYN. For OB, I spent some time in clinic doing prenatal visits and ultrasounds and some time in Labor and Delivery. For GYN, I spent some time in clinic doing gynecology visits and procedures and some time in the OR doing gynecology surgeries.

After this one week, I can say confidently that I LOVE OB/GYN. Seriously, what an awesome field of medicine! You get a perfect combination of clinic time (most attendings only did about 2 afternoons per week) and operating room time! I realized that I love the OR...both during C-sections and with Gyn surgeries. You get a great combination of procedural work and "medicine". You get a great mix of healthy and sick patients. You get a great fulfillment with bringing life into the world or with performing surgeries on women to alleviate suffering. It really is such an amazing field!

Positives: EVERYTHING! The mix of patients/OR/clinic/preventative medicine; many of your patients are coming in happy and leaving even happier, lots of interactions with other specialties (especially in the ER) and the excitement that comes with L&D and the OR.
Negatives: The crazy hours and crazy malpractice insurance...

Week 4: General Surgery

Going in to this rotation, I was kind of terrified. When I was told "you start at 5:45 AM", I thought this would be the hardest week of my life...even though I was really only following the residents around with no real responsibility. Yes, it was very busy, but I had a really really great experience. We spent about half of our time in the OR and half on the wards with Pre-op and Post-op patients. This week was really great for me as a medical student for a few reasons: I saw a crazy amount of diversity of cases and pretty much everyone there was very very sick. While I would never wish illness on anyone, as a student who needs to learn proper medicine, I was thankful for the opportunity to see all that I got to see.

Positives: Excitement of the OR (Yes, I clearly love the OR), lots of procedures, and lots of interactions with other specialties.
Negatives: Surgery residents are not always the happiest people, crazy hours.


So, going in to this externship I was pretty confident that I would be going into Peds. However, after this, I could honestly see myself going in to any of these 4 fields....but if I would have to pick this second, I think I would actually have to pick OB/GYN..I know I have a lot of time to decide, but for now...I will say that I am so so so excited for third year!

Endocrinology Shadowing

I havent blogged in a few weeks because of my crazy crazy exam schedule. I knew this semester had a lot more exams than last, but its kind of amazing how much material we have already learned and been tested on this far. In fact, I have my first final of the semester, in immunology, this Friday!

Like I mentioned in Fall v. Spring, one of the neat things about the Spring semester is that we get way more clinical experiences. One of these required clinical experiences is shadowing our faculty mentors in either their clinic or in a hospital. My faculty mentor, an endocrinologist, is actually gone for a few months to do research in Florida, so I shadowed one of this partners in his endocrinology clinic. Although I shadowed physicians as an undergrad (as everyone hoping to enter medical school does), I was nervous to see if the expectations and experience would be different now that I'm no longer "pre"-med, but instead a real med student. Well, I definitely was right to fear there would be different expectations....

After first meeting my physician that I was shadowing, I was immediately handed a CBC. Although we "practiced" reading CBCs in biochemistry, when you are handed your first one and asked "whats wrong with this patient", it is much much different. Luckily, my normal guess of "anemia" proved to be correct (point 1 for Kailyne)! After talking about our first patient, we went in the room to see our first patient. After talking with her and examining her, the physician told me to listen to her heart and lung sounds and to tell him 2 things that I find that are abnormal. Well, considering the fact that I am just now learning heart and lung sounds (2 weeks after I shadowed), I had no clue of what to do. My patient was very nice and told me that I should be looking for a murmur, but of course, I still don't really know what that sounds like (negative one point for Kailyne). After this, the next four hours seemed to go up and down like this. I would correctly guess that a patients medicine was causing hyperprolectemia, and then fail at describing Graves Disease (something else I learned just 2 days after this shadowing experience). So, I know that I am not expected to know everything, but every time I would get excited that I knew something, seconds later I would be reminded that I really don't know much...Oh well, I guess I am going to have to get used to it because of the nature of my future career!

In the end, I am really happy that I got this shadowing experience to begin to prepare myself for what I will expect in 3rd year rotations. I realize I will no longer be able to hide in a classroom answering multiple choice questions when I am one-on-one with a physician/resident and in patient rooms. I know I still have more than a year before I will have to face this reality, but I definetely want to get more shadowing experiences under my belt before I have to go in as as a third year, who is really supposed to know what the heck they are doing! *Gulp*

Casting Clinic/Scrub Session

There are a TON of student interest groups here at CHM. Basically every medical specialty has an interest group, which offer a ton of different speakers, panels, or clinics that give insight into what their specialty is like. I have gone to several events that these groups have offered, but my two favorites have been the Casting Clinic and the Scrub Session.

If you want to shadow surgeries, you must first get trained in how to make sure you are providing a sterile environment for the patient that is undergoing surgery. There is a meticulous process that must be followed, starting with washing your hands like CRAZY, to how your robe is tied, to the proper way to enter and exit the operating room.  I knew that this was an important part of surgery, but to actually learn the process was pretty awesome.

Casting Clinic: The Family Medicine Interst group put on event that taught us how to put on/ take off a cast! We partnered up and put on all of the materials. We then took a lot of permanent markers and signed each others casts like we were in Jr. High (obviously!!). Finally, we learned how to use the saw to take off the casts. The final step was definitely the most nerve racking part of the process, because we were afraid of hurting each other, but no one was injured! It was such a fun clinic...I can't wait until I put a cast on someone who actually has a broken bone!