Much has happened since the last time I wrote. I finished my review paper, got it approved, received some of my clinical rotation schedule, already finished the psychiatry rotation at Sheppard Pratt and am 2 weeks into the internal medicine rotation at Harbor hospital.
So let's start with psychiatry!
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Sheppard Pratt Psychiatric Hospital
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6 weeks at Sheppard Pratt psychiatric hospital flew by. It was overwhelming at first - as you can imagine we had information overload...hospital protocols, new schedule, new patients, learning not to get lost in the hospital (trust me, the last one was harder than you think!). Being in a hospital with real patients is completely different than just reading about suicidal behaviour. It was very surreal in the first week when you sit with a patient and ask about suicidal thoughts, homicidal thoughts and severe depression. I was surprised at how comfortable patients were discussing such personal issues. Overall I actually enjoyed psychiatry more than I had thought. I really liked getting to know patients, their stories and by that I mean not just their 'medical history'. Psychiatry is one of the few specialties which really relies on knowing the full picture; social aspects of a patients life is just as important as their medical symptoms of depression. Assessing and managing a patient includes psycho-social evaluations. I loved sitting down with the treatment nurse, the social worker and the psychiatrist to check-in on patients daily. Once the patient would leave everyone would say their impression of the story we had just heard, we'd call a patients family to get another perspective and include both their and the patient's request on how to manage them. Are they safe to be out in the real world? that was the golden question, the one that decided if they needed to stay in the inpatient program or can continue as outpatient treatment. The down sides to psychiatry? there was no practicing of hands-on medicine and I feel like I would miss that. Most of the management of a patient was medications and therapy... the therapy portion I liked, the medication monitoring not so much. The pros of psychiatry was definitely the amazing schedule and lifestyle it allows. It is a specialty in which you can choose to do research in your free time and that is something I will be pursuing no matter what field I end up going into.
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My friend from Saba and I looking all professional
on our first day of internal medicine |
Suffice to say I liked the rotation and will most likely going back in november to do an elective in adolescent/child psychiatry :)
Internal medicine is a totally different basket of eggs! I have only started 2 weeks ago and I find myself going to take a history of present illness report from the patient and asking them more questions about their social situation than I probably should. Although it is important, IM deals with emergent cases at times (especially [and obviously!] when we are doing admissions from the emergency department!). I need to stop thinking like a psychiatrist!! haha. So far I am in the overwhelming stage of IM... long hours (12 hr shifts are the norm and we have night call as well as long call 7am-9pm. Oh, did I mention we work 6 of the 7 days a week?). So yes, still adjusting to the schedule and the early start time! But all in all I like the patient interaction and the fact that we get to use our physical exam skills everyday. Something about hearing the patient talk about their symptoms and then confirming it with palpation or auscultation is very thrilling! :)
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| 6:30am sunrise from the Harbor hospital parking lot. |
As far as I am in my clinical rotations I can say one thing for sure: people are truly sick. I know this is such a general statement but when you read about stage III kidney failure, or about pancreatitis, or about anaphylactic shock it doest not sink in until YOU see it. I am starting to link all my book knowledge with the corresponding patient and it is a great way to build information. I find that I am learning so much more, so much faster than at Saba!
Oh and for those of you reading this and are preparing to start rotations, get ready to feel like you do not know anything all over again! We are once again merely medical students trying to stay afloat and catch our breath... its going to be a great ride.
