Two Months

"You don't always win,
but every time you lose, you get better."- Ian Somerhalder, Actor

Forgive me for my lack of explanation regarding how the Internal Medicine rotation really works and what my responsibilities are whilst on a team.

In a nutshell, the rotation lasts a total of two months. We are divided up into two teams based on the class size from each campus of the UWI; these teams are then broken up into smaller teams of 2-3 students who are then assigned to one of the five Internal Medicine teams. Each team rotates between two of the 5 teams during the 2 month rotation.

Some teams are structured which allows you to plan your weekly schedule and manage your study time and ward time; others, unfortunately lack structure and due to this, discipline and good time management are your saving graces as you try to learn as much as possible whenever, wherever you and from whomever you can.

We are  responsible for having our procedure book as well as attendances to clinics, ward rounds and calls signed off by a Supervisor by the end of the rotation. Procedures range from taking 10 histories and performing physical examinations and presenting your history during rounds or while on call to your Registrar, Senior House Officer or Intern. As we're all human, our immune systems have its moments where it just isn't up to par, and as such sick days are to be documented and a sick slip is to be turned in to Administration and your team members are to be notified.

Calls are every 5 days and during calls you are responsible for clerking at least 2 patients which you will be responsible for following until they are discharged along with familiarizing yourself with the other patients assigned to your team.

It helps tremendously if you either create a census for yourself that you edit daily to reflect each patient's progress, medication changes and decisions that are agreed upon during rounds and any significant clinical finding. This worked for me to ensure that I had something to read about each evening or to catch up on over the weekends or during calls. It also shows that you are interested in learning and understanding how to efficiently and more importantly, accurately manage patients.

The above is an example of how I organized my census using Google Sheets. The advantage of using Google Sheets is that you can share it with your fellow team members and you can access it from your mobile device if your hospital has an open internet service or if your service provider is reliable and you're able to get data during your ward rounds. It allows you to make changes on the go so you are always up-to-date on the management and decisions made at the bedside during rounds.

As far as the resources I utilized during my two months of IM I cannot say that I reached for one resource more than another.  My IM arsenal included the  Davidson's Principles and Practice of Medicine, Kumar and Clark Clinical Medicine, Oxford Handbook of Medical Sciences, Oxford Handbook of Clinical Medicine, as well as Toronto Notes and Up-to-Date.

As you transition to your next rotation, be sure to relish the journey. The experience is invaluable and the patients you will encounter will change your outlook if not for a lifetime, a moment. Don't take on every little criticism or beat yourself up if you answer incorrectly during rounds, just know that whatever it is you'll just have to work a little harder at it.

All the best for a new week!