Family Medicine Elective

My first months of 4th year have already come and gone.  I took the boards a month and a half ago and promptly went on vacation.  I had a blast spending time with my family and catching up with a few friends.

On returning, I started my Family Medicine elective.  I designed the month with the help of the lovely Family Med department at my school.  The first two weeks were spent in a private practice in the 'burbs.  I wanted to work with an energetic, young female so that I could try and imagine myself in their shoes.  It worked!  I had a blast and could almost imagine myself 5 years down the road in my shiny new practice.  I spent the second two weeks at the local Family Medicine residency program.  I worked with each of the attendings and several of the residents, attended lunch lectures, and even visited a couple of their other sites like the nursing home and OB clinic.  I got a better feel for what residency will be like and really liked all the people I worked with.  It was a great month in that it affirmed my decision to enter the field of Family Medicine.

Luckily this was a pretty laid back month, which allowed me to work on my residency applications!  It wasn't all that hard really, but there are a lot of pieces to put together like getting a headshot, writing a personal statement, choosing which programs to apply to, making sure you have all your letters of recommendation from faculty members.  And finally this past weekend I got to submit the thing.  It felt like a lot of weight lifted off my shoulders.

Now I am back in the hospital working in the ICU.  Today was my first day and I have to admit it was overwhelming seeing such incredibly sick people and not really understanding a lot of the interventions being used to treat them (ie, ventilators).  Lots of learning to be had this month!

I'm a 4th year!

It's amazing to write that third year finally came to an end!  It was a very long 12 months learning the ropes of the clinical world.  Those first few rotations were rocky at best, my classmates and I learned the simplest things like writing daily progress notes and what "following" our patients means.  Now with those concepts down pat, we have grown into baby doctors and can spend the majority of our time focusing on diagnosis and management of our patients' conditions.  It's a great feeling!

4th year will be more of the same, but we'll see some new settings and have just a tiny bit more responsibility for our patients (of course, our senior team members will still have to oversee our actions) and become a more integral part of the decision making process.  Here's a sneak peak of what's to come:

Block 1: Study for Step 2 Board exams
Block 2: Family Medicine advanced elective
Block 3: Medical-Respiratory ICU
Block 4: Emergency Medicine
Block 5: Interview month/Rosetta Stone-Spanish
Block 6: Geriatrics
Block 7: Endocrinology
Block 8: Reading month (aka, vacation!)
Block 9: Update course
Graduation!.....Residency!

I have a feeling it's going to go crazy fast.  Hold on to your hats!

Psychiatry

This is by far the hardest 3rd year clerkship to write about.  I finished the rotation in mid-July, if that's any indication.  But for completeness sake, I have to write it.  I spent the entire 6 week Psychiatry rotation at an inpatient treatment center for children with acute psychiatric illness.  This was not a site I wanted to be placed at.  For one, my big buddy had to leave half-way through the rotation a year prior because she was so miserable.  I'm also not too crazy about pediatrics.  Third, it was the last rotation of the year and this site is rumored to be the most time-intensive of all our psychiatry sites, so no one was really interested in putting in long hours at this juncture in our academic careers.   So it came down to drawing names out of a hat, naturally.  And what do you know, lucky me got picked!

Team drama aside, I was placed at the treatment center with some very lovely classmates and it turned out the staff was very lovely too.  Since it's an inpatient center, there is a lot of support for the kids including doctors, therapists, social workers, occupational therapists, teachers, nurses and even a therapy dog!  The thing that was not so lovely were the stories.  It was stuff out of television except when you watch TV it seems like it's not real and you can turn it off and go about your regular activities.  I felt like I was trapped in the TV and I had to watch and learn about all the physical and psychological aftermath of the horrors these kids have been through.  Within the first two weeks I began experiencing symptoms of vicarious traumatization, which can take on many forms, from anxiety/depression to actual PTSD-like symptoms that results from empathizing with victims of trauma. I was definitely not alone, I found after talking with my classmates on the team.  And born out of our distress is a research project my classmate and I are taking on!

The rotation did get easier and I learned to take some comfort in knowing that the kids truly were receiving the care they needed.   And I am also grateful for the experience.  I learned how to work through my own emotions so that I can take better care of patients.  I was pushed harder than I have ever been pushed before, and I know my interviewing skills improved by leaps and bounds.  And I get to be a part of this great project.  So, not so bad in the end.