Friday, July 1, 2016

Another July 1

Another July 1 is here, and this time I am a second year. It's bizarre to watch another cadre of interns come in, especially ones I knew as medical students.

It's a strange experience to think, after a long workday on July 30, "I'll be a second year tomorrow." I'll hold the ER pager. I'll do the crash repeats (the emergent C-sections on people who've had C-sections before) and the crash classicals. I'll run the list. I'll do the MIGS cases.

Last year, I heard people saying to the second-years, "see how much you've learned?" I know more than the new interns, but I don't know how much. I still haven't finished my Gabbe. I still haven't studied the things I missed on CREOGs (in-service exams during residency).

Before I start romanticizing a little too much, let me say: it's not as abrupt a change for me. I'm doing my ICU month first, so I'm still an acting intern this July. Even so, the difference between me and the medicine interns is dramatic. I know how to put in orders, I finished my note 15 minutes before rounds (and theirs still aren't done), I know how to present a patient. Even though I'm the off-service rotator, I was the one called to do the emergent new patient, because most of them still needed  help from the R3 for orders. (Not that big a deal though, the R3 came in to assess vitals with me...and it was even something I know how to deal with--acute anemia.)

But it's interesting.

I'm studying for STEP 3 this month. This is the last exam I will take before I have a medical license to practice independently. It's not the last exam I will take in my life, because I want to be board certified in OB/GYN, which means CREOGs and Boards (final exam at the end of residency to make sure I can start a job) and periodic recertification. STEP 3 is a two-day long multiple-choice test, with some (apparently) weird formatting in questions to simulate real-time case management of acute patients. I'm not super excited.

I think I'm a calmer person and I can now recognize when a person is really sick, and when a pregnant woman is really uncomfortable. I think I'm becoming a good doctor. I see a lot of potential in my career and the future seems bright. I still expect the day when I will make my first Big Mistake, the one that will make me look back on this time wistfully, wishing I could go back. I don't fear having adverse outcomes; I only fear causing them.

There's a very important blog post coming up, one about faithfulness to calls. And that's all for today, because the ICU attending (who is a complete genius) is expecting me to present on neuroleptic malignant syndrome in an hour.

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