This post is late. I completed my Internal Medicine rotation last week and this means an update is due. The problem is, I loved Internal Medicine. In this rotation I felt for the first time that I may finally be entering the transition zone – still a student, but also a doctor in the making. I’ve been holding off on writing this entry because I wanted to do justice to the many things I learned in this rotation, but there is no time. I’m already 1 week into orthopedic surgery and it is now or never for Internal Medicine…
This rotation was where we saw complicated patients too sick to be sent home from the Emergency Department, but not sick enough for the Intensive Care Unit. Each patient came in as a puzzle and it was our job as the CTU team (10-14 people) to sort out the puzzle pieces. Our mornings began with group rounds in the main-floor conference room where a list of patients would be handed to each person on the team. Each patient was discussed and assigned to a family practice resident or a medical student to follow for the day. On any given day I had as few as 2 and as many as 5 patients to see. I would look up lab results and X-rays, check medications, listen to hearts and lungs… The senior physicians would see every patient on the list before the day was through. As a student I got to see the puzzles come together, and on lucky days I put a few pieces in myself. It was real medicine.
And we always work with incredible people…
I felt a strong connection with Irena (centre), an experienced international physician who works as a liaison between the CTU and the medical program. She spent hours of her own time (for which I am certain she is not compensated) to go over the details of discharge and transfer paperwork with us. It mattered to her that we learn this basic skill because the transfer process between doctors can be a life or death detail for our patients. She was also the anchor in this rotation for us. She fielded our questions, helped us with our consults, and was the go-to in our department to teach the residents how to do practical medical procedures like chest tube drains.
Sanjay and Mohammed (above, far left) were our UBC residents for the first two weeks. They were brilliant and fun and got us off to a strong start. We were sad to see them leave.
Gareth (above, far right) was the family practise resident who shared the block with us for the whole rotation. He was super – still close enough to his student years that I never felt silly asking him questions, but far enough from his clerkship year (our year) that he knew the answers!
Dan (back left, Internal Medicine resident), Amy (back centre, CTU pharmacist/invaluable team member), Sonny (back right, 2nd year Internal Medicine resident), Ana (front left, 4th year Internal Medicine resident) and Dr. Lakhani (front right, CTU attending physician for 2 of the 6 weeks). Everyone in this picture was awesome, but I must make a note about our junior resident Sonny because we spent 4 of our 6 weeks directly under his supervision.
By convention it is the 2nd year resident who runs the CTU as part of their training and I was struck by the way patients responded to Sonny. In this environment it is key that you can gain the confidence of both your patients and your colleagues. Every doctor has their own way of doing this and he had a gifted balance of assurance and humility that caused our patients to connect with him strongly. (I am always watching the physicians who oversee our learning because I am convinced that ‘bedside manner’ is a skill – not a personality trait). His professionalism was worth emulating – thanks, Sonny!
I lucked out on our last day. Dr. Olsen (our rotation lead, left) and Dr. Bishop (long-standing Internal Medicine specialist, right) were both in house for our final exam so I snuck a last minute photo with them. I had the privilege of learning from Dr. Bishop in my first-year for a 4 week block of case-based learning. He is such an experienced and respected physician. It is amazing to me that he continues to invest his time in our earliest stages of foundational learning. Dr. Olsen was our rotation lead for this block. She was lovely to work with – smart and kind and she took every opportunity to teach us as we worked our way through various clinical problems.
Missing from this post is Dr. Iqbal (attending physician for 3 of our 6 weeks) and Dr. Mader, (a local GP who works closely with CTU). I’m sorry I missed their photos – the whole rotation was a super experience filled with talented physicians who took an interest in teaching. I was sad to say good-bye.
Up next…2 weeks of Orthopaedic Surgery! (Except, I’m already 9 days in – next update coming soon!) 🙂