I just came back from my Emergency Medicine rotation at the St. Maarten Medical Center with Dr. Houston, and I must say, it was a great experience. I saw fifteen different cases of all sorts and severities, including trauma, high fevers, inflammations, unconsciousness, septic shock, and bowel conditions. I even heard what lung crackles sounded like for the first time on a real patient! The greatest thing I took back home today was seeing the entire thought process going through the doctor’s mind from the moment the patient comes in to when the patient leaves, from interviewing the patient (or caregiver of disoriented patients), to physical exams, to deciding what lab tests to order, to interpreting the lab tests, to making decisions on treatment, and how to educate the patient.
It was really cool seeing how everything we learned in ICM (Introduction to Clinical Medicine) and our Basic Science classes come together in the real world. It was actually a great feeling seeing the doctor do certain manual maneuvers during the physical exam and knowing exactly why she’s doing it (and being able to do it myself). It was also a great feeling reading lab results and knowing exactly what the numbers suggest about the patient’s condition. I was surprised seeing seemingly unimportant details we learned in class actually coming back to be applied to some of the patients we saw today. I was also surprised at how “textbook” many of the cases we saw today were, many of which could easily be one of the made-up cases we discuss about in our ICM small groups.
This is the first of two rotations that I am required to do for ICM 5, a class which we all take during our last semester of Basic Sciences at AUC to prepare us for the clinical years of our training. During my rotation, Dr. Houston was happy to answer any and as many questions that I had. She even let me interview a few patients! As it was the emergency room, where we don’t have the luxury of time, the interviews I did today weren’t quite like the long, detailed interviews we learned to do with standardized patients (actors) in the classroom. Nevertheless, I still applied many of the same skills such as introducing myself, starting the interview with open-ended questions, and OLDCARTS. The doctor even let me write up a patient’s HPI, Assessment and Plans! Like any other med school rotation, I got pimped quite a few times with questions testing my knowledge of medicine. I was able to answer many of them, but the ones I could not answer, it was a learning experience nevertheless. I enjoyed the rotation so much that I ended up staying 6 hours, 2 more hours than what was required of me. Dr. Houston welcomed me to come back anytime if I wanted more shadowing experiences.
My next four-hour rotation will be two weeks from now, in which I will be rotating with a surgeon in the operating room. I’m really looking forward to it, especially after being a TA (and a head TA) in the anatomy lab for three semesters. It will be my first time seeing any kind of surgery (other than the fake appendectomies we did on cadavers during AMSA’s Advanced Suturing Workshop, which does not count!). Before then, I’ll have to brush up on my anatomy!