previous rotations: Obstetrics & Gynecology, Family Medicine

I was going to wait and write my impressions of my third clinical rotation until after I got my evaluation from the attending. But he is taking his time and I hear he’s (still. again.) browsing this site during the big group 10am meetings.

Embarrassing, yes. But not as bad as if I was actually in the meeting. Hi, everyone! I miss you all!

daily schedule:
7am – meet with fellow students (3 or 4) and interns (3 or 4) to go over patient list (anywhere from 12 to 18).
730am to 10am – pre-round on your patients and write SOAP notes.
10am – meet with the attending, case manager, social worker and entire Silver Team (yes, there is a Bronze and a Gold team).
1130am – start attending rounds in the ICU.
12 or 1230pm – break for lunch.
1 or 130pm – meet back again and finish work rounds.
4 or 5pm – go home.

actual daily schedule:
Pretty close to above, except a few of us students usually added 30 minutes into the pre-round time for breakfast. There were also days where we were done by 2 and others that stretched to 6pm.

what to wear:
As we are encouraged to observe or participate in any procedures being done to or on our patients, wearing scrubs is totally appropriate. But if you like to dress in a similar manner to your attending, then you’ll want to wear dress slacks and a button-down long-sleeved shirt. If it’s cold, toss on a nifty sweater or vest. And don’t forget your white coat and name badge.

what’s in my pockets:
- stethoscope
- small notebook with a list of patients, labs & data
- pen
- phone with Epocrates Drug Reference
- Maxwell’s Reference
- Cecil got bonus points for having q-tips and a tongue depressor on hand one day
- Washington Manual of Medical Therapeutics (okay that wasn’t really in my pocket, but I often carried it around)

patient notes you will be asked to write:
This is your most classic example of a blank-page SOAP (subjective, objective, assessment, plan) note. Our attending didn’t seem to care if the lab values came at the beginning of end of the O and the A/P is mostly a work-in-progress during third year.

If a new patient is admitted to your team, you may also be asked to conduct an H&P. Work on a kickass history and physical. And be able to present it in a logical and coherent fashion, including pertinent positives and negatives. Leave the non-pertinent stuff out.

what to study:
Study your patients. Know their diseases inside and out. If your rotation is anything like mine, you will see the same things over and over (diabetes, pancreatitis, stroke, etc). Diagnosis, assessment and treatment will all sink in a little more each time you see the same thing.

After a few weeks, you’ll look back and take for granted everything you know now and didn’t know before. Most of the time during this rotation I felt like a complete idiot. And yet, this was my favourite rotation so far.

a few unforgettable things learned along the way:
- I can calculate TPN (total parental nutrition) in my sleep! Word!

curious things other students do:
- wear shirts that show cleavage
- include observations in their SOAP note that they didn’t actually observe
- spend a lot of time on their phone

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