One Block Down, Seven More to Go

My first of eight 6-week blocks is done. And now I finally have the time to write about it. All third year medical students (MS3s) at Temple are required to do Medicine 1 at Temple Univ. Hospital (TUH) in North Philly, and that is where I have been for 40-50 hours a week for the last 6 weeks. Here is how a day in the life of an MS3 went in internal medicine at TUH:
I woke up at 5:45 and proceeded to shower and eat breakfast. I got on the road at around 6:15 to 6:30 and got to TUH about 30 minutes later. My resident and intern liked to start work rounds at 7:30. So this gave me and my MS3 partner about 30 minutes to pre-round. Pre-rounding is going to do a quick history and focused physical on the patients that I was following. Rounding with the residents consisted of going to see every patient in our service (usually between 10-18). During this time my partner and I presented our findings from that morning to our residents. The presentation was in SOAP note format. This stands for Subjective (what the patient tells you), Objective (what you find on your physical exam) and the A/P (assessment/plan, what we planned to do about each issue the patient has). The hardest part for us as MS3s was coming up with a plan. We knew how to do a history and physical on a patient, but we kind of got a little lost on the treatment part. Work rounds ended around 9:30, at which time we would attend a lecture or conference and take time to write progress notes on our patients. We would meet with our attending physician (the head honcho of our team) around 10:30 and round with him for an hour and a half. We would discuss patients and he would add his input and recommendations about each patient, then write his own progress note. After this we would break for lunch. Us MS3s would then go to resident teaching conference, where a third year resident would teach us for an hour. So around 2pm we would head back to the floors and get some work done. Around 3-5 we would head home. But the residents would usually stay longer and get more work done.

Then there was CALL. Every fifth day (whether it was a weekday or weekend) we would be on call. For MS3s this meant one of us would stay overnight with the team, while the other one would stay till about 9-10pm. And the best part was that we could all wear scrubs (soooo comfy). The next day (post call) we would leave at noon.

Overall, I think I learned a ton. What I also found out was how much I didn't know. I wouldn't be able to take care of patients on my own anytime soon, but I think that I understand a little better how treatment of hospital patients is managed.

On Monday I start Medicine block 2 at Crozer-Chester Medical Center. At the end of that I take a big test. This test, plus my faculty evaluations, will determine my grade in the class. So far, my first evals will be good (or so my attendings told me), and hopefully I can improve for next block. Then I will get a much-needed week of vacation. Oh, did I mention that I am loving third year? I really am, it is just keeping me busy every day, whereas the first two years were only busy when I had to study for tests.