Happy Friday, everyone!

I just finished the first week of my internal medicine clerkship. This clerkship is 12 weeks long, with 8 weeks of inpatient medicine as well as 4 weeks of outpatient (clinics). I started off with two weeks of inpatient medicine and will finish off my first month with another two weeks of inpatient hematology/oncology (so excited). Starting third year has been quite the whirlwind. I chose to start with internal medicine because I recently took Step 1 and the material is still pretty fresh in my mind. It’s also supposed to be a great foundation for the rest of clerkships. So not only is internal medicine the longest clerkship, it also seems to be the most important in terms of how residencies look at your third year performance!

Monday started off with a morning orientation and then I had to report to my assigned team that afternoon. My team consists of two interns (PGY-1), a second year resident (PGY-2) and a senior resident (PGY-3). The residents were informed that we were brand new third years and that this was our first day ever. So basically they knew not to expect a whole lot from us the first day. That afternoon I followed my resident as we saw some patients in the ICU that were being downgraded to our service and even got to translate for a patient, something my team was super grateful for (apparently having a Spanish-speaking med student is quite the luxury!). I stayed at the hospital until 6pm for sign-out to the night team. At sign out the day’s patient’s are discussed, including any significant changes to their management so that the night team knows what to expect.

Tuesday was what I would consider a “typical day” on inpatient medicine. The morning started bright and early at 5:45 am. I was assigned my very first patient who was in the ED (emergency department) and was being admitted to our service. I performed a full H&P (history and physical) and then prepared my presentation before rounds. Rounds typically occur around 9am for us, so I had a couple of hours to get familiar with the patient’s history and fine tune my presentation. As we walk from room to room, patients are presented to the attending and we discuss any important things that happened over night. We also decide what needs to be added or changed to the patient’s management, what other specialties need to be called for a consult, and what labs or imaging needs to be done. Rounds are a great time to learn new concepts or realize that you don’t know something. My attending will ask me a few questions here and there, this is something called “pimping.” Pimping can be pretty stressful but I’m lucky to have a very kind attending, though I’m sure I’ll encounter many other attendings with different personalities along the way.

Rounding can last until 12 pm at which point the attending goes on to do his own thing and the patients are left in the care of the rest of the team. While the residents and interns deal with patient orders and procedures, my job is to help them do their job the best I can. This can include anything from calling for a consult, scheduling a specialty appointment, requesting records, or even translating. By 6pm the night team has arrived for sign out it’s time to go home. My senior residents have been really nice and I’ve been pretty fortunate to be excused a few hours early each day, which has been a treat since I’m fasting and being on my feet all day can be somewhat challenging.

One thing I noticed about internal medicine on my rotation, beyond the fact that everyone works extremely hard is that there is a genuinely kind and enthusiastic culture to it. I’m actually enjoying internal medicine a lot more than I thought I would and learning a lot about the physician I ultimately aspire to be.

Have a wonderful weekend!  