This is the second month of my hospital rotations. Last month I was working in a family care clinic. It was a good place for me to start on as they simply threw me in with the patients and I got a lot of practice taking histories and physicals. One of the docs is scheduled as the attending physician each day that is in charge of the med students and residents. As a student, I would go meet my patient, gather information about why they are there, obtain other history, run through a review of systems to ferret out any other current problems, and a physical exam that seems appropriate to their visit. Then, armed with all the info I could think of asking, I would excuse myself and go present to my attending physician. Sometimes you have to wait in line but there were usually only a few of us and the residents require less of the attending's time anyway. My attending would then, without fail, ask a bunch of questions that I had not thought about. Then they would ask me what I think was going on and what should be done and finally they would go in the room to meet the patient with me to ask those questions I didn't think to ask and to repeat some of the physical exam themselves. They'd discuss whatever needed to be done with the patient and we would exit to go print out whatever prescriptions, lab orders, referrals, etc that were needed. I can't sign anything as a med student so the attending has to sign all those papers. Finally, I'd pop back in, give the patient the papers and sometimes some drug samples, and conclude the visit. Then I had the joy of charting the visit! Ugh, since I'm still figuring this all out, not only did the visits themselves almost invariably take at least an hour but I took another hour to write it all down. Usually I had my next patient scheduled and had to wait till the end of the day to finish charting. The charts I had to submit to my attending so they could check them over and sign them off. I was usually brain fried by the end of the day, which often went from 7am to 6pm, but I gained a lot of practical experience which I am glad for.
This month, I am working with a surgical urologist who has his office right by my hospital. He sees patients on Monday and Tuesday at his practice. The rest of the week is a mix of office visits with surgical procedures at the three hospitals in the area. My base hospital is actually made up of two hospital campuses, Mercy and General, that partnered together to form a single hospital system. Between the two campuses on the freeway is another hospital called Hackley. My doc sees patients at all three of them and he is a tall man so I am usually jogging to keep up with him in the hallways because I would most certainly get lost if I wasn't with him! It has been already a very interesting rotation working with my doc. I learned how to change catheters; I got to participate in a prostate biopsy and an inguinal hernia repair. I've watched some bladder scoping (thankfully they usually have a camera so I can see what's happening on screen), putting in ureter stents between the bladder and kidney and putting in a suprapubic catheter. A suprapubic catheter goes into a hole that the doc makes from below the belly button into the bladder to help drain if the usual catheter isn't doing the job. I even saw the process of breaking up kidney stones with shock wave treatment and how they put in the radioactive seeds for prostate cancer treatment. And this was all in the first week!
Well that kind of summarizes my third year experience so far. We have a lot of 7am lectures so I am often going to bed at 10pm. There are also a number of lunch meetings, afternoon lectures on Thursdays, and morning lectures on Fridays. Some of those meetings are journal clubs so we have articles to read beforehand and they expect us to be reading about everything we're seeing anyway. They keep us pretty busy but I've had the chance to go fishing a few times when we have nice weather!
