Farewell to the Big Three
>> Wednesday, December 28, 2011
Three Fates by ~vivalastan on deviantART
Yet again it's been forever and a day since I last blogged here! o_O Holidays have come and went: Halloween, Thanksgiving, and Christmas. Before I could take notice, even the seasons have come and gone: summer, autumn, and now into winter.
Where was I during all this? Mired in "the big 3" rotations: - 2 months each of internal medicine, surgery, and pediatrics. Because this has practically dominated my life since the beginning of M3 year, it's only fitting that I spend some time elaborating on some of my thoughts regarding these 3 rotations. Here I'll only give a brief intro to each, with the next several posts going into some more detail.
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Medicine (July, August)
I first began describing internal medicine in this post several months ago. Again, internal medicine (usually just referred to as "medicine") is the prototypical idea that people have of what a doctor is - someone with a lot of medical knowledge who listens to you, physically examines you, then orders a bunch of tests and prescribes medications with the hope of figuring out what's wrong and getting you better.
My 2 months of medicine were exclusively inpatient; that is, spent entirely in the hospital on wards. My first month was on the hospitalist service at one hospital, then I was on a ward team at another hospital for my second month. The ward team structure is very hierarchical consisting of 2 M3 med students, 1 M4 med student, 2 interns, 1 senior resident, and 1 attending physician. The med students must "pre-round" before the rest of the team on their patients and then present their patients to the team during rounds. Rounds is basically when the entire ward team goes from patient room to patient room and discusses the action plan for each patient that day.
Surgery (September, October)
In contrast, surgery was an entirely different beast. Whereas on medicine the day began with rounds around 8am to 9am or so, surgery rounds frequently began before 6am and occasionally as early as 5am. The hours were grueling as the days rarely end before 5pm and too often later. While surgery also contains a similar ward team structure, each patient encounter goes much quicker because the first surgeries of the day typically begin around 8am.
Surgery was truly a love-hate relationship. I hated the hours with a fiery passion. I hated some of the people I worked with. And I hated standing for hours on end in the OR (operating room) - my lower back never hurt more than it did on surgery. But I loved doing something tangible with my hands - dressing wounds, removing drains, removing staples, removing sutures, removing lines, suturing, etc. I loved the act of scrubbing into the OR; not sure why, but there's something ritualistic and almost sacred about it.
Pediatrics (November, December)
Pediatrics (more affectionately called "peds") was a world apart from either medicine or surgery. In essence, it's the children's counterpart of medicine. At its core only the patient population differs, but that singular difference is more profound than one would think at first glance. With children come parents and families. And it's a rare occasion to find a child without an adult nearby. So when you address the patient, you're also addressing his/her guardian - if not the entire family. It requires a particular kind of skill to not only deal with kids, but also keep parents in the loop.
The benefit of the peds rotation is that one month is inpatient (with all the trappings of ward team structure) and one month is outpatient in a community clinic. The contrast between inpatient and outpatient is quite literally like night and day, and that deserves a post in and of itself.
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P.S. And why have I chosen a picture of the Fates to represent the big 3? Because, like the Fates attending to the loom of life and death, these 3 major branches of medicine are also intertwined and have to rely on the expertise of the others. It's an intricate balance and each one deserves respect (which incidentally can be a topic and post in and of itself as well, lol).
Where was I during all this? Mired in "the big 3" rotations: - 2 months each of internal medicine, surgery, and pediatrics. Because this has practically dominated my life since the beginning of M3 year, it's only fitting that I spend some time elaborating on some of my thoughts regarding these 3 rotations. Here I'll only give a brief intro to each, with the next several posts going into some more detail.
-----
Medicine (July, August)
I first began describing internal medicine in this post several months ago. Again, internal medicine (usually just referred to as "medicine") is the prototypical idea that people have of what a doctor is - someone with a lot of medical knowledge who listens to you, physically examines you, then orders a bunch of tests and prescribes medications with the hope of figuring out what's wrong and getting you better.
My 2 months of medicine were exclusively inpatient; that is, spent entirely in the hospital on wards. My first month was on the hospitalist service at one hospital, then I was on a ward team at another hospital for my second month. The ward team structure is very hierarchical consisting of 2 M3 med students, 1 M4 med student, 2 interns, 1 senior resident, and 1 attending physician. The med students must "pre-round" before the rest of the team on their patients and then present their patients to the team during rounds. Rounds is basically when the entire ward team goes from patient room to patient room and discusses the action plan for each patient that day.
Surgery (September, October)
In contrast, surgery was an entirely different beast. Whereas on medicine the day began with rounds around 8am to 9am or so, surgery rounds frequently began before 6am and occasionally as early as 5am. The hours were grueling as the days rarely end before 5pm and too often later. While surgery also contains a similar ward team structure, each patient encounter goes much quicker because the first surgeries of the day typically begin around 8am.
Surgery was truly a love-hate relationship. I hated the hours with a fiery passion. I hated some of the people I worked with. And I hated standing for hours on end in the OR (operating room) - my lower back never hurt more than it did on surgery. But I loved doing something tangible with my hands - dressing wounds, removing drains, removing staples, removing sutures, removing lines, suturing, etc. I loved the act of scrubbing into the OR; not sure why, but there's something ritualistic and almost sacred about it.
Pediatrics (November, December)
Pediatrics (more affectionately called "peds") was a world apart from either medicine or surgery. In essence, it's the children's counterpart of medicine. At its core only the patient population differs, but that singular difference is more profound than one would think at first glance. With children come parents and families. And it's a rare occasion to find a child without an adult nearby. So when you address the patient, you're also addressing his/her guardian - if not the entire family. It requires a particular kind of skill to not only deal with kids, but also keep parents in the loop.
The benefit of the peds rotation is that one month is inpatient (with all the trappings of ward team structure) and one month is outpatient in a community clinic. The contrast between inpatient and outpatient is quite literally like night and day, and that deserves a post in and of itself.
-----
P.S. And why have I chosen a picture of the Fates to represent the big 3? Because, like the Fates attending to the loom of life and death, these 3 major branches of medicine are also intertwined and have to rely on the expertise of the others. It's an intricate balance and each one deserves respect (which incidentally can be a topic and post in and of itself as well, lol).
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