Rotation #6: Internal Medicine

During the month of February, my husband did his second rotation in Internal Medicine. In fact, he was originally scheduled to do this rotation with someone completely different, but he had heard really good things about one service in particular. Since he has been contemplating between Anesthesiology and Internal Medicine, he talked to his rotation coordinator and had her switch his schedule to accomodate this particular rotation. It took a few pulling of strings, but he was able to make the switch and I believe that he was very glad that he did! We knew that this rotation would be more difficult in regards to hours and energy and we were definitely right!!

From the spouse perspective, this was a VERY difficult rotation for me!! The hours were long and my husband oftentimes worked longer than some of the residents. In fact, he was actually on for 19 days straight with NO break!! This included on-call time as well!! However, I really think that this rotation was very valuable to my husband for a multitude of reasons and in the whole scheme of things, do not feel negative in any way for not being able to see my husband! First of all, he learned a TON of information (which he will explain in further detail below) and came home very excited about the things that he learned. Secondly, he did AMAZING on his shelf exam, which would have helped him in either specialty that he was interested in. And, lastly, and in my opinion the most important, this rotation was able to help him to officially decide what he wants to do with his life!!! He was able to more fully discover his strengths and weaknesses and even his desires, and has made the decision that has been plaguing us for months about what he wants to do for the rest of his life . . . he has decided to go with Anesthesiology!! From my perspective, I am very excited about this change!! At first, I was a little worried because he has always talked about doing a specialty within Internal Medicine, but the more and more we discuss it, Anesthesiology is a much better fit for him!! Now, we just have to apply to out rotations and residencies, but we will get to that later!!!

Here's my hubby's thoughts and opinions . . .

I will start out by saying that this rotation was just a difficult, if not more so, than my surgery rotation (and those were some long days). However, I can honestly say that I learned more on this rotation than I did on any two of my previous rotations combined. That’s not to say that I didn’t learn a lot on my other rotations (I learned a ton on most of them); it’s just that I learned a lot on this one. Internal medicine is the base of all other rotations and it never hurts to have a good foundation before going into whatever specialty interests you.

During this rotation you are working directly with the residents of the internal medicine program at the hospital. You work with them all day and take call with them. The attending physicians will round with you during the day and they are fantastic. They all teach and they are very patient. However, the majority of your teaching comes from the residents. It makes sense since they are with you all day and with you during your call nights.

The typical day begins at 6:30 a.m. (now it’s 6:15 a.m. I think). You meet with the residents for sign-out from the on-call resident (the resident that was on the night before). You print out your list of patients and divvy up the new ones among the students and residents. We then have morning report at 7:15 a.m. (which we are required to go to) and at around 8:00 a.m. we start seeing our patients. When you begin rounding is dependent on the attending you're with. The first two weeks of my rotation we were with an attending that liked to start rounding at around 10:00 a.m. which was plenty of time to see your patients and sometimes discuss them with the residents before rounds. As a side note, we would usually have around 3 patients as a third year medical student. This was enough, and by the end of the rotation you were able to handle the patients fairly easily. Rounds would take anywhere from 4-6 hours with this attending making for a fairly long day. After rounds you would either get a small presentation that you, a fellow medical student, or resident put together. We would then do H & P’s on any new patients in the ER or go home between 5 and 6 p.m., if there was nothing left to do. During the second two weeks of my rotation the attendings were switched and my new one liked to round at 8:30 a.m. I would have to come in around 5:00 a.m. and see my patients just to be ready in time. However, we were done rounding early, leaving more time for teaching. We still wouldn’t leave until 5 or 6 p.m., but it seemed like a more educational day.

In addition, you did have call responsibilities. It was usually one night a week and two weekends over the four week period. When all was said and done, I had worked 19 days straight at the hospital making it very exhausting. Like I said though, I learned a lot.

At one point I thought I wanted to do internal medicine but have since switched to anesthesiology. However, this rotation makes me see the draw to internal medicine and its benefits. You work hard during the rotation but you learn a lot. I would recommend it to anyone.