Friday, January 8, 2010

Seeing Patients in Clinic

At U of I, at least here is Rockford, we have what is called a Family Medicine obligation. For us second year medical students (M2s), that means we spend one half day a week in the clinic. We started this even before we had completed all of our work for History and Physical Examination knowledge.

As we continue to work, we are learning things about how to interview a patient, write-up a report, diagnose problems, and prescribe medication. Epocrates is my friend. Epocrates is this fabulous application for PCs, Macs, Blackberrys, iPhones, etc. It's so useful. If you want to check it out, go to This site has everything you could possibly need to get through clinic as a medical student.

I used it today to diagnose a patient. Of course, I had to have the basic clinical knowledge. I had a thought of what her diagnosis might be. I pulled out my Blackberry, hopped on Epocrates, and looked up the disease. I was informed of the basic symptoms, what I'd see on exam, and expected patient history. I was told about the best ways to treat it, drug interactions, and counterindications. That's just the tip of the iceberg. If you are going to go to medical school or join the medical profession, get Epocrates.

I am just really enjoying the experience though. Each new experience (at least the ones where the woman is pregnant or needs a pap smear) brings me closer to realizing that I'm interested in OB for real. This makes me happy. I'm just the kind of person that gets happy when at the end I want the same thing I wanted in the beginning.

Male GU Workshop

We've been doing a workshop to learn about a Male GU check-up. GU stands for Genito-Urinary. We have done a full clinical skills class for everything except GU for men and women. I've just completed the male portion. It was quite the experience. Just like the rest of our clinical workshops, there was a process.

We had a brief orientation where we learned the basics of what was expected of us. Then we were responsible for reviewing the relevant material in Bate's Guide to History Taking and the Physical Exam. Then the very next day, we had a demonstration on the proper way to conduct a genital and prostate exam. I was completely unprepared for my reaction.

First of all, I've seen prostate exams before. I've done preceptorships with doctors who perform them. But it's quite different when someone is doing it slowly for educational purposes. And I was awful close to the proceedings. Like, really close. Really really close. I was taken aback and slightly embarrassed. I still don't know why. I really hope I don't have that same reaction when we do the females. Because that would be my first indication that I really might want to look into something else besides Obstetrics/Gynecology. Because right now I know for sure that I should never be a Urologist and maybe not even in Family Medicine.

I really can't figure out my reaction. For the workshop where we had to perform the exam (multiple times on different men), I was so incredibly nervous. I literally needed more oxygen; I couldn't breathe very well. My heart was beating so fast. I had to leave the room and go to the bathroom. But once I got to the exam, I did it very well. My father swears I'm going to have horrible bedside manner (I'm pretty sure he's joking), but every time I have to deal with a patient, things always go so well. At least so far. But that nervousness was there. And each time we switched to a new person, the nervousness came back.

I got through it somehow, and I feel better knowing I am more proficient at clinical skills, but the Male GU exam will not be a part of my practice of medicine as an actual physician.

Medical School So Far

This blog is jumping in halfway through my second year of medical school. It's been quite a journey thus far. I will occasionally reference old things in a effort to fill in the history, but I'm going to continue from the present for now.

At this point in medical school, my school life is a constant juggling act. I attend University of Illinois, the Rockford campus. This campus is all about Family Medicine. This is great for any medical student interested in practicing medicine in of the primary care areas. You get a lot of exposure to Family Medicine, Pediatrics, OB/GYN, the basics. There are good opportunities for other specialties as well. But it's clear where the focus lies. Great for me that I want to do OB/GYN.

These days, lots of talk focuses on preparing for USMLE Step 1, AKA the Boards. I'm looking forward to it because once we cross that threshold, it means my life will be almost all clinical, and very little classroom work. That makes me happy!

Right now, we're about 80/20 for clinical/classroom. There's still so much to learn, but almost all of it is interesting. And luckily, confirms what I think I want for myself in medicine. We shall see. I'm doing my best to keep an open mind. Who would choose a specialty before they get to see what it's like on the doctor's side?

But at this point, I'm trying to balance staying on top of our current workload, prepare for clinical work, start preparing for the Boards, keep on top of my family, friendship, and romantic relationships. It's quite the life, being an M2 (second year medical student at U of I - Rockford).
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