Sunday, November 02, 2008

Tips for Doing Well in the Internal Medicine Rotation

If you've been reading this far, you know I'm not a huge fan of internal medicine. But one thing about rotations you hate is that you don't want to take them twice. So, here are my thoughts on doing well on inpatient IM:

1) Don't complain. Everyone hates scut work, most people hate being on call, and a lot of people hate rounding for hours and hours. But no one likes hearing someone else gripe about it.

2) Do as many procedures as you can. Tell your intern that you want to learn to do procedures. Be around while the team is on call. I got to do a lot more at night when there were no attendings around.

3) Read about your patients. Medicine is a huge subject, and it can be overwhelming to figure out what to read. It's a good idea to get a general text to use (I liked Step Up to Medicine). But you should read in greater depth about the diseases your patients have from a more detailed and authoritative resource like Harrison's or UpToDate.

4) Offer to help your intern do their scut work. That way, you'll both get done sooner, and your intern will hopefully repay you by teaching you something (or even better, letting you go home early).

5) Participate in rounds. Insist on presenting your patients when the team gets to them. Join in on the team discussions as much as you can.

6) Fill out your patient logs DAILY. As painful as keeping up with logs on a daily basis can be, it will be a lot more painful if you try to enter them all at the end of the rotation, or even at the end of the week.

7) When you're preparing to present post-call, don't try to keep all of the info on each patient in your head. Write notes to yourself on an index card, or print out your note from Epic so that you can use it to jog your sleep-deprived memory. One great strategy is to print two pages of your note to one piece of paper. That way, you won't be constantly shuffling the pages while you present.

8) Check on your patients and make sure there isn't anything they need. A lot of patients are lonely in the hospital, especially on weekends and holidays. You're there anyway, so you might as well brighten someone else's day. Plus, you might learn something interesting that will help the team take better care of that patient.

9) Get to know the support staff. Tell them your name, and find out theirs. Ask your patient's nurse how the patient did overnight. Talk to the social worker and case manager about your patient's disposition.

10) When you're rotating at CCF, you will be wearing a long white coat, and people will mistake you for a resident. Always try to act like the future doctor you will become, but don't ever lie about your actual status as a student.

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