Continuing Journeys

A lot has happened since I last posted!!

A New State

I literally moved across the country to a new state on the west coast to start my pediatric residency.  It's still kind of weird being here.  I'm not used to the mountains . . . the Midwest is very flat.  I suppose I'll have to conquer my fear of heights sometime in these next 3 years, haha.

Orientation

Let's just say that orientation was off to a rocky start.  5 of my co-interns and I were a few minutes late returning from lunch to our PALS (pediatric advance life support) course, and the instructor refused to let us enter and complete it because she had already begun the video - from what we were told, we weren't missing anything vital anyway.  The 6 of us comprised half of the intern class . . . you can't have half the intern class not be PALS certified by day 1!!  We were furious, the program coordinator was frustrated, and the department chair was livid.  It got resolved but not without taking a hit to our pocketbooks, sigh.

EMR (electronic medical record) training was painful as always.  You can only tell us so much before we zone out or forget.  It's painful enough to learn 1 EMR system during orientation, let alone 2.

My co-interns are a tight bunch.  They're funny, laid back, and pretty helpful.  I hope this doesn't change as we progress through residency.  It would be quite sad if we ended up at each other's throats towards the end.

Day 1

Day 1 for us was not July 1st as it is for many programs, but rather the Monday before (June 24th).  No matter what, I'm pretty sure Day 1 feels like [this] for everyone.  I was lucky.  I started on an outpatient subspecialty block, genetics.  I've now survived 2 weeks of residency, yay! :-D  On one hand that's not saying much, as I'm basically a glorified (read: paid) med student in genetics clinic.

My interest in genetics has waxed and waned over the years.  I started off med school super gung-ho about it but it soon fell out of favor.  My time in genetics clinic here thus far has renewed some interest in the subject.  It's fascinating from an academic point-of-view, and far from always being a life-limiting/death sentence, there's a lot that a geneticist can do for patients.

First and foremost is a diagnosis, simply putting a name to something so bizarre can greatly help parents and families.  Second is anticipatory care for the patient.  Some genetic disorders come with a plethora of potential cardiac, skin, nervous system, etc issues - so having a name helps guide screening for problems right as they occur so they're easier to take care of.  Third is future planning.  Some genetic disorders happen de novo (basically, randomly out of nowhere) whereas others are hereditary.  This is important to know for parents wanting to have more children, or for the patient him/herself when they're older.

It's hard to believe that these weeks are moving by so quickly!  While I have a better appreciation for genetics, I don't feel like I've seen enough!!

Continuity Clinic

A hallmark of any pediatric/internal medicine/family medicine residency program is the continuity clinic.  Clinic was one of my favorite arenas in med school, so I was looking forward to it.  It's one of the major reasons why I applied to pediatrics as opposed to anesthesia.

That said, my first clinic patient took me over an hour to see.  It wasn't because I spent all that time with the patient, no, it was because I was wrestling with the EMR system trying to figure out how to place orders, schedule follow-up visits, write a progress note, etc.  I don't think I've ever simultaneously felt more and less like a doctor than at that point.  Sadly this was an EMR I had used as a med student, but apparently there are a lot more buttons to click and tabs to go through as a resident compared to a med student . . .

Night Float

Today I'm about to start night float for a week, going from 6:30pm until 8:30am (roughly).  I'm excited and scared at the same time.  I'm going to be covering an arena of peds that I hadn't really been exposed to before - the NICU (neonatal intensive care unit) and the newborn nursery.  I will be relying on the back-up and support of my senior resident and attending heavily, at least for the first day or two.  Wish me luck!