Friday, August 26, 2011

Med Student Life and Premed Questions, pt 2

Third and fourth year. Today I shadowed a third-year as she rotated her fourth week in pediatrics. I followed her in an outpatient setting. She had a good deal of independence. (She plotted growth/height milestones, decided which shots the child should have, saw the patient, took a history, did a physical exam, counseled parents, and then presented to the doctor. The doctor then checked her work and repeated an abbreviated version of this to make sure everything was covered satisfactorily.)

She told me that she spends about half her time in the hospital (inpatient) and half in the clinic (outpatient). She is on call two weekday evenings (5:00pm to 11:00pm) and one weekend (8:00am to 11:00pm); during this time, she has to be within 20 minutes of the hospital and have her cell phone with her (they can now use phones instead of pagers). On the weekend call day, she visits each hospitalized patient (a.k.a. she "rounds" on them or she "does rounds") and assesses their progress. The doctor checks her notes and she goes home (just a few hours in the hospital). Overall, her assessment of peds was "pretty gentle."

She impressed me. She wasn't as smooth as the physician but she knew all kinds of questions I wouldn't have thought to ask, she could listen to heart sounds in the right places, and present like a pro. "This is a six-year-old male who came in with a firm, non-erythematous swelling of the third digit of the right hand, retaining full range of motion...possible bone fracture, rule out...." At the same time, I knew that she was not too different from me. She was a little nervous, she reviewed her books between presentations, and she half-bluffed some of those heart sounds (I'm not completely blind...). I have a lot of hard work to do, but I think I can become like her eventually. (By the way, I didn't know there were books like hers, books not on science but just about clinical pediatrics or obstetrics or whatever. How nice! That means I don't have to store it all in my brain. Just most of it....)

Ask third- and fourth-years what their rotations are like: what is a typical day? are you in the hospital or the clinic more? are you independent? how much? do you like that? are you on call? what nights/days/weekends are you on call? do you rotate alone or with a group? how many students per faculty member on these rotations? do you enjoy their time or feel pressured? why did you choose to do rotations in the order you did? did you get your first choice of rotation orders? do you know what specialty they want to enter?

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