Monday, September 27, 2010

Starting my internal medicine rotation

I started my clinical rotations in July of this year. (These traditionally occur during the third year of medical school. For me, it's my fourth year, since I did a fellowship year.) I have been able to ease in - my first two months were surgery, which is normally a difficult rotation, but is a fairly mellow one at my rotation site. This past month I have been on my psychiatry rotation, which has also been a low demand rotation, time wise. I have still been able to cook dinner most nights, and have been (mostly) keeping up with the cleaning and the laundry. I was even able to pull off a birthday party for my newly six year old younger son this weekend.

Well, the easy street is merging into the internal medicine superhighway. I have three months of internal medicine starting October 1st. I am really nervous about it. I have back up to help me with the kids, but I am still dreading it. I am especially concerned since my stint stretches over October, November, and December, and all of the holidays associated with these months.

So, coffee? Check. Comfortable shoes? Check. Penlight? Fresh batteries. Big fat pocket book that promises to have all the information on all of the diagnoses, drugs and lab results that I may see in the units? Ordered and on its way.

Sigh. Any other recommendations for surviving these next three months?


  1. A diploma in diplomatic skills should help in dealing with the sub-specialities. A third hear will do the numerous calls for everywere. You must also benefit of a cup of tea before trying to explain the families about the waiting times of the things you will ask (lab tests, x.rays, CT...). Good luck!

    InĂªs Leal, Lisboa, Portugal

  2. Thanks Dr. Leal! Ha ha, a diploma in diplomatic skills. That could really be helpful.

  3. Deep breaths. If you can stay internally calm with all the demands and craziness around you, you're golden. And don't be afraid to leave if an attending says you can go--they are offering and it won't make you look like a slacker.

  4. Um, don't forget to enjoy all the amazing things you will learn from your patients, your residents, and your attendings.

    Being a mom in medicine is hard. But we chose it, right?

    Good luck!

  5. compassion. A little bit goes a long way and the more you can give out to your colleagues and patients, the more you'll get back in return when you really need it. Plus, it doesn't cost you anything to be nice, especially to the nurses. A tasteful joke can get you a long way.

  6. the best advice I got at the beginning of rotations? Instead of aiming for survival, try to enjoy the ride and live the experience. You'll never have this opportunity again, afterall.

    And I agree - leave any time the offer is given.

    Enjoy your time at home - when you're at home, BE at home.

    Learn as much as you can and try to teach your team something along the way.

    Be kind - to yourself and to everyone you meet.

    Spend the extra minute to get the warm blanket, fill up the water, or reposition the patient before you leave their room - what a difference a few minutes can make.

    My kids never realized when we celebrated holidays a day/week early/late (ok, maybe this one doesn't work for Halloween)

    Communicate effectively.

  7. Since the advice to take a deep breath is taken, the next thing I would suggest is to check your own pulse. If you feel extra harried, stop a minute and check your pulse(or breathing or whatever) to give yourself some calm. Also rememb er that you may actually enjoy it. I still get a thrill from the unknown diagnosis and joy from knowing my intervention made a difference. Don't let your worry take away your opportunity to use everyhting you learned during your second year in pathophys.

  8. Thanks for all the advice! I am pretty sure I am going to enjoy myself when I am with the patients, residents and attendings. I love medicine and love learning about it. It doesn't hurt to be reminded, though.

    I am more worried life outside the hospital, with the juggling act and the long hours. I hope my kids don't mind celebrating holidays late, or missing a few dinners and breakfasts with mommy.

  9. I just finished 3 months of internal medicine and have three little kids at home. It was busy, but not nearly as bad as I expected! Honestly, in retrospect it feels like I blinked and it was all over.

    The kids did fine. I still had time to pump every 2-4 hours for my still-nursing-like-a-newborn 19 month old, and while call sucked (short call so I didn't really see the kids for a 2 day stretch) the kids are no worse because of it.

    You'll be fine! Just have fun. :) I have no intention whatsoever of going into internal medicine but I learned a ton and didn't hate it (which is what I expected going into it).

  10. As much as you can, try to leave work at work. Carry study stuff with (note cards, print outs of topics to read) so you can study for a few minutes here and there - then you won't need to study so much at home and won't feel guilty about it. Pick a few goals for your life outside the rotation - like sleep, time with family- and let other stuff, like housework, go for a while. I don't have kids yet, but these tricks have worked for my husband and I as I plod through residency.

  11. OUTSOURCING! Don't do any work at home that you can get (pay, if possible) someone else to do. Don't cook or clean or do laundry. Get hubby to kick in more if needed--mine responds nicely to me putting in the loads of laundry and letting him fold). Freeze some favorite meals ahead of time. This (and very helpful mother and MIL) is how I got through NICU fellowship (with 2.5 hrs of commuting each day!) with a child.

    Good luck!

  12. @ Breastfeeding Anonymous - How did you manage the pumping while on your medicine rotation? I start MSIII this July and The Husband and I are planning for a baby (hopefully within a year). I would love to have some advice on how to successfully manage breastfeeding while a med student on a wards service.

    Just discovered this blog and am very thankful to you all for your contribution of time and


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