I’m halfway through my Emergency Medicine rotation, having already completed three months of Internal Medicine (general adult medicine). Unfortunately I don’t think I’m any closer to knowing what I want to do with my life, except I guess that it’s definitely some branch of medicine!
My first month was ambulatory medicine (general adult care in the office setting) except that it wasn’t; I was with a pulmonologist who spent half of his time in the hospital and half in the office. Probably 80% of the time was lung-related problems, though he did an admirable amount of general medicine work, which I have the impression is unusual for specialists though I don’t know for sure. He would, for example, notice that a patient was extremely anemic (or, even better, he’d pay attention when I noticed and pointed it out), and make sure that the patient got the appropriate workup and treatment. And he saw some patients in the office who were just general practice, or who were not really his patients but were really in need of treatment (his dry cleaner’s wife, or some such person, was having trouble with depression and he let her come in that same day; as he told me, she might be better served by a psychiatrist but she’s not about to see one, is she?). So I did actually get a good picture of medicine.
I very much enjoyed working in the office, seeing lots of patients but getting to know them, and coming up with plans. Most of the downsides were due to being a student - it’s somewhat stressful to spend all your time with one person for a month and depend on them for your grade, no matter how great they are, and having little control over what you’re doing is rough as well. The hours were a little hard, but we were only working 10 hours a day; the bad part was that it was far away so I was also spending up to 2 hours a day in the car, which does eventually get tiring. So while there was some unavoidable stress (tracking down lab results, getting staff to do things that needed to be done, making difficult decisions, etc) that is always going to be part of a physician’s life, I thought outpatient internal medicine sounded overall like an excellent choice.
Thoughts on other rotations to follow, at an as-yet-undetermined interval.
The St. Louis Public Library is running a program this month called Read Down Your Fines. For kids 17 and younger, every 30 minutes they spend in the library reading erases one dollar of library fines. How cool is that? When I was a kid I could have used that. I used to have to spend my lunch money to pay my library fines, then I would have to eat lunch on a dollar a day. (Don’t ask why I didn’t ask my parents for more money. I was a weird kid.)