Boards, then WARDS

Monday morning my journey through medicine continues. The third year begins my last two years of medical training -- the clinical rotations or "clerkships" as they used to be called. First the Class of 2008 has some house-keeping stuff to take care of at our class meeting at 8AM Monday morning. This will also serve as an orientation and "welcome" to the clinical years. There might be some important information given regarding policies and procedures, as well as guidance given in choosing and applying for a residency, so I should probably not skip this. You see, somewhere after third year, medical students normally apply for their residency training. This training takes anywhere from 3-5 years, or a little more if a sub-sub-sub-specialty is chosen. And even though I just finished Step 1 of the Boards, I have to take Step 2 sometime during 4th year -- which will be here before we know it. So we have quite a bit that we could cover in a couple of hours at our class meeting. After that I have to meet with the 7 other students ("Crozer trackers") who are doing all their rotations at Crozer-Chester Hospital. We have our own little orientation specific for our clinical campus. After that, at 1PM I have an orientation meeting for my first rotation -- which is six weeks of Internal Medicine at Temple (see pic above). This is also referred to as Medicine 1; Medicine 2 will be another 6 weeks of Internal Medicine at Crozer-Chester Hospital. Well, I'm not sure exactly what I will learn during this day of orientations, but it probably won't be a lot of medicine. Just a lot of necessary administrative stuff.

Go to this website (courtesy of my google calendar) to see what rotation I am on at any given time. Of course, I will try to blog about each rotation, but I will probably be too busy during some to even write a word or two on here.

So, how do I learn during my clinical rotations? I will certainly let you know how... when that happens. But for now you will have to be happy with my understanding so far. The clinical years are truly "hands-on" learning. I will have real patients to take care of, take histories, and perform physical exams. I may even learn a few procedures along the way. I will be part of the team of doctors and nurses that take care of people in the hospital. I am supposed to learn how medicine is practiced clinically. So that I don't kill any of the patients, there is a certain hierarchy that goes on in any teaching hospital. The third year medical student (MS3) is at the bottom of the totem pole -- probably won't be making any patient care decisions any time soon. Directly above me, is the fourth year medical student (MS4) also called a subintern. I don't get evaluated by him/her, but said person may be a valuable source of information, since they were just in my shoes only a year ago. The person that I will report to is the Intern -- someone who is just beginning their post-graduate training (i.e. they are in their first year of residency). They are also not too far removed from my current "lowest on the food chain" position. They may have some say in my evaluation (which partly determines my grade for that rotation). Above the intern are the higher-up residents, and then the Chief Resident, which is someone who is in their final year of residency training for their specialty. This guy/girl is almost a full-fledged practice-anywhere doctor. Above that position is the Attending Physician -- usually called the attending. Notice how this is the only title that has the word Physician in it. The intern and the resident are both medical school graduates, and thus doctors, but they are called their respective derogatory titles until they finish residency. The attending is the one who will write my evaluation for the course. S/He is also the one that I will probably see the least, but who will also be the most impressed by my vast amount of basic science knowledge (LOL). Well, to tell you the truth, the attending has been out of medical school for a while. And I have just finished my basic science courses. So s/he might be unnecessarily impressed by some of my knowledge. The basics of third year seem to be: expect to mess up and not know everything, work your butt off to learn everything you can about your patients diseases and get your scut work done, and try to work the politics in your favor (i.e. get a recommendation letter from an attending that was really impressed by all your hard work and knowledge). Well, I think that is enough for today's lesson. I will definitely try to update this blog as often as my shedule allows. Basically, I kind of know what to expect for the clinical years in a nutshell, but the great big oak tree that grows out of this nutshell is just going to blow my mind -- and I probably couldn't do it justice in a few blog entries.