GIM Weeks 1 and 2

Alrighty! I am already halfway through with my first rotation! And today marks 355 days until graduation. But who's counting? I can definitely tell that this year is going to be one of the fastest of my life so far.

My first rotation is general internal medicine. It's outpatient, so I work in a primary care office. It's a little disappointing that I'm not in the hospital for internal med, and this rotation is probably going to be very similar to my family medicine rotation, but that's ok. At least I have a cushy schedule! I'm an 8-5er, with only half-days on Fridays. I work with a nurse practitioner 3 days a week and a doctor twice a week. They are both very different so it's good to learn from them both. It's been a bit of a challenge adapting the things I learned about history taking and physical exam to real patients who come to see this doctor all the time and have chronic problems instead of acute issues.

Most of what I have to look up/study these days is pharmacology. What I generally remember from pharmacology is drug classes, but suddenly I have to know specific drugs (trade names and generics) and their specific dosages, side effects, interactions, etc. I have met some patients with very interesting diseases. Chronic diseases are the norm. By the time I'm done I should be a pro at blood pressure drugs. I've seen a lot of people in chronic pain, and learned quickly how to recognize patients who are drug-seeking and need to be sent to pain management. I'm realizing how frustrated I feel with many of these processes that we really just don't have a lot of options for. My preceptor has taught me that most of medicine is not about "cures," and I think that's a little bit of a depressing fact. I do feel overwhelmed looking at a patient's medication list that is 10+ drugs long, or trying to sort out a 81-year-old's medication history when they're not really with it enough to tell you what's going on.

But it's rewarding too. I do love connecting with a patient. It's a really neat feeling, and it really helps them to make changes or to do the things that are hard for them in order to take care of themselves. And helping a patient to help themselves is the best thing ever.