Going back in time - 1st month IM rotation

First of all, I just wanted to thank those that had made comments on my last blog. I really didn't expect anyone to have kept checking up whether or not I was still writing, which makes me feel bad but really does make me want to continue on! Maybe it was the wedding planning with rotations. Or actually I bet it was because I had moved back home I could bounce things off my husband moreso than when I was away all the time. It is probably possible that I felt that I might not have needed the blog anymore... I have found though recently though how much I had missed it and actually that I might be able to get advice or give it to other students (and start sparing my hubs from my venting, haha!) In any event, thank you again and will try my best to keep up with it!

So I thought for this entry I would take a little trip back to June of 2009, my first month of my IM rotation. Pretty much was heading into a new hospital system and a quite well known one as well which made it more nerve-racking. I had been asked about how I was able to get a spot there since it was not an affiliate. Well, actually none of my 4th year elective is at affiliate facilities either, which is something else I should speak about. I obviously was sick of moving and I wanted to be home with my little family more than anything and I was willing to do anything I had to in order to do that. I does depend on your state as to how many elective you can do as a non-elective but for me it was alright. Generally it requires you to contact the medical education coordinator and jsut ask how to apply. They will tell you what you need to fax them and this is where the Ross Non-Affiliate Rotation form comes in. Once you submit that to Ross and you submit your application to the hospital, Ross will then process your application and send your transcripts, scores, vaccination records, etc. to the hospital. This takes about 4 weeks, sometimes less if you are lucky. Once it is processed the hospital will contact you that your rotation is set up. Generally this is probably just as easy as an affiliate hospital but just a couple more hoops to jump through. I have done this throughout my whole 4th year and some of my 3rd too. It doesn't take too much and definite worth any extra effort!

Anyway, so I was fortunate enough to meet much of the IM staff over the years with a relative working there. Getting to meet them and stay connected throughout my first couple of years in school, I was able to maintain some contact to hopefully one day be allowed to come for my core. I was very lucky and as far as I know, it was very hard to even get that for me. It took me six months (actually at least) for this to be ironed out with administration, faculty, etc. I was getting nervous as months were going by without it coming up on my schedule. Eventually though it worked and I was signed up for 3 months of IM! From that time, I was able to meet more people in medical education and was able to secure a couple more months of 4th year. Basically, this was all possible through the inital connection. It would be really nice if we could get that affiliate back as I know they were once ours before. From what I see, I know that we would totally rock as students for this facility. Most seem very impressed with my efforts and I feel very comfortable and welcomed to this hospital!

Getting back to my first month, I was placed in hematology/oncology. It was in June so I was placed with an intern and senior resident both about to advance in their training the next month. I have to say, I have actually ALWAYS had awesome teams to work with and this team was just the start of me realizing it! This floor, while the turnover was less - meaning longer stays for patients - it was a busy, busy floor. Basically anyone with potential cancer or someone admitted for a health reason who had a history of cancer was admitted to our floor. We had call q4, though only had to spend the night on Friday/Saturday calls, otherwise they were till 10pm. I had my own patients, though yes unless it is a sub-I, the intern is still in charge of those patients. I just pretty much followed hers. I would do as much of the admission that I could as she taught me how to write the orders, H&P, etc. I would be able to do my pre-rounds, present them daily, keep up on their daily orders/tests and have some responsibility of doing their discharge summary updates in preparation for their discharge. It was great being given so much responsibility! I really felt liek a part of the team. I was even lucky enough to start getting my own med students! I had probably 2-3 recently finished 1st years come in to shadow, here's the funny part - me! It was really great though because it was at this point where I found out how much I have really learned. Their experience in clinical science was little to none so pretty much anything I was doing or seeing could have a teaching aspect to it which made my day that much better!

I tried my best to help in calls, though my team really wouldn't push much to wake me up sometimes but really I wanted to help. I didn't just let myself sleep through my rotation, lol. Anyway, patients on this floor really touched me and for some reason I really wasn't disheartened by these people who in great proportion were in hospice. In this month, I was given great exposure to end-of-life talks with family which was hard at first. I even had a patient that was such a pivotal point in my education, he became a huge part of my personal statement. It was with this patient I had spent two weeks with, through him learning of his terminal illness, to help managing his treatment and be there for his final days. It was even with this patient I gave my first family talk, completely alone mind you, as his passing took place between visits. Maybe this is something I could post for an example for future applicants if anyone would like to read it...

Anyway, staff were on this floor as well, some of whom still recognize me today 8 months later and still are great to chat with! My senior as well the heme/onc fellow were wonderful about letting me get exposed to procedures too. This month I was able to a thoracocentesis and a bone marrow biopsy on my own. The biopsy was a tad difficult pushing hard enough, so yes I had to get help from that but it was great. Maybe it was how hard I worked that they allowed me a chance to try my hand at a procedure.

All in all, this month was fabulous and I am seriously considering a fellowship in hematology/oncology. I really enjoyed my time and I know that must sound so morbid but I felt like it was a place where I belonged. It also seems to be a less stressful fellowship (althought mentally I am sure it could be seen as challenging) to choose from. I have been told that to apply for fellowship requires preparation as soon as my internship year. While applications and interviews begin in PGY-II year, connections, recommendations and research should be pursued from the beginning. I am not sure how true this acutally is but at least if I chose to do this, I think I might have a nice start. I have been doing research for some time now in the heme/onc department and am currently on research project #3 (I will talk about in another blog!). So at least I am some comfort in knowing that I am on track in case I would like to pursue this!

Well, this has been quite a long post but next up I will be talking about my general medicine month, which was my second of my IM rotation! :) As always, let me know of any questions! Talk to you all again soon!