With the New Year coming and the move into the clinics this fall an update is in order.
The last few months it has been quite a change. I took the summer easy, spending a lot of my time with my family and a few projects including those mentioned here. In early September the class had a short orientation then was dispersed to hospitals and other practices. Finding a balance between studying for each rotation, time for my family, myself and other projects hasn’t been easy. The call shifts especially have been difficult; all you feel like doing afterwards is eating greasy food and sleeping.
This year is the move from theory to application. Over the year we will all cover the core specialties: Internal Medicine, Surgery, Family Medicine, Psychiatry, Paediatrics and Obstetrics/Gynaecology. A lot to take in and many times learning is divided into 2 week blocks, so just as you begin to feel comfortable you must move on to a new area. A few practical tips are summarized here.
Since September I’ve covered Paeds, OB/Gyn, and am in the middle of Medicine. Like many I felt a bit lost at first, part of this was related to knowledge, but much of it was the practical aspect of medicine (writing a progress note, dictating, presenting a case, consulting another service, the materials needed for a procedure, to cut knots too long or too short…). These practical and communication related aspects took time and were not well covered in pre-clerkship.
Time on the wards has also afforded many opportunities to learn from those more experienced, most of the residents I’ve worked with have been eager to teach. It takes some time to be comfortable heading down for a consult or reporting an acute ER case to a senior, hoping you’ve covered all the relevant information. I’ve learned the hard way a few times, been harshly criticized and tried to take it in stride. There are also some very positive encounters with patients. Knowing people rare want to be in the hospital I listen and do what I can to help. I’ve had a few patients/families thank me for the little I’ve done.
Looking forward the next few months are a time of making decisions. Next fall we do electives in order to learn skills and make good impressions in the hopes of landing interviews and ultimately the residencies we desire. The portal for applications is now up, a new service this year that attempts to simplify applying for electives across Canada. It still has some bugs, but a way to make the process more streamline is great. With all that, we must narrow down our career paths, some already knew coming in, many changed their mind, but it is still a stress. I have ruled out a few, but am still on the fence. Soon I’ll need to make a few choices, like many in my class, and then see where my journey in medicine leads.