My AICM 5th Semester On-Call Experiences

As you know for the AICM 5th semester, we have 8 weeks of introductory rotations to complete. And within these 8 weeks every student is required to complete 4 on-call shifts: 2 for Internal Medicine, 1 Family Medicine, 1 Surgery, and 1 OB/GYN. For me AICM is completed and as I prepare to head to my home state I found a little time to write this post to give prospective students a heads up on what to expect.
Internal Medicine
For IM, we have to do one shift in a weekday and another in the weekend. In a weekday we have to complete a shift from 8 PM to 8 AM the next day. On a Saturday or Sunday we have to complete a shift from 8 AM to 8 PM. During the weekday shift, it’s was tough for me, since I have to stay up all night. On my shift I had to take history and physical for a new patient and present the case to the on-call resident who’s on the floor. He doesn’t go to the patient, instead he listens to what I got from the patients and he looks over the patient’s charts. Most of the times the nurses on the floor will take care of the patients who are admitted while the medical students and the residents joke around and goof off in the residents room. During the night, each medical student will take turns to sleep for couple hours or more while the other students admits new patients or check up on other patients who are already admitted. I can’t sleep in the hospital so in order for me to drive home safely I consume as much caffeine as possible so I can drive home awake. After my shift was done at 8 AM, I had to attend the morning report which lasted till 9 AM.
Family Medicine
In this rotation, we have to come in during the day to complete our duties in the Family Medicine clinic. After the clinic closes, which is around 4:30 or 5 depending on the day, we have 3 hours to do whatever we want. At 8 PM we have to join the Internal Medicine students and basically do Internal Medicine on-call shift. And just like Internal Medicine, we have to show up for the morning report.
OB/GYN
This is one of the most boring shifts I have ever had. It’s not that the OB/GYN rotation is boring, it’s just that there isn’t many patients admitted to OB/GYN for us students to see anything. OB/GYN and Pediatric students are side by side because the nursery is in the OB/GYN area. The on-call shift for this rotation is from 8 AM to 8 PM.  I went to the OB floor and put my cell phone number and name so the nurses can call me whenever they need me; it’s mandatory. After attending the morning report, I had to go to the Family Medicine clinic and sit with the attending while a senior student reads his/her presentation. After his/her presentation the attending explains the topic presented form his/her experiences.  Afterwards, I went to the floor of the clinic and helped out the residents till the clinic closed.  For the rest of the day I go to the Internal Medicine floor and the OB floor back and forth.  During my on-call shift there were two ladies who were in labor but there were a lot of students around so I didn’t stick around much, I went to the Internal Medicine floor.
Surgery
The surgery rotation is another boring rotation since you don’t do anything. You basically stand back and watch patients in surgery. Most of the appointments are not even surgeries, they are nothing but colonoscopies.
What is a morning report?
The morning report is a routine seminar everyday in which a resident presents a case in front of medical students and an attending and describes how he/she diagnoses the patient. After the resident completes his/her presentation, the attending takes over. The attending, which can be any doctor, goes further in the subject and explains the case and the cause of illness of the patient. This seminar takes roughly an hour or so to complete. Within that hour you will see other residents and medical students eating their breakfast or checking their FaceBook on their iPhones, or whispering about what to do in the weekends.
Is there any attendance rule?
All students scheduled for the on-call rotations have to have an attendance sheet signed by a resident or an attending after the on-call shift is completed. The education office of the hospital will also give out three meal tickets per on-call shift which accumulates to $15 in lunch/dinner or $9 in breakfast. At the end of the semester the sheet must be turned in along with all the other paperwork and assignments to the education office. The medical office will give each student a grade and submit that grade to Saint James Medical School which will count for rotations.
Dress Code
Medical students on their on-call shift will have to wear scrubs. These scrubs are given by the hospital. And no, you don’t have to pay anything extra for them.

AICM Pre-Clinicals Recap

As you know AICM is mandatory for our class. I want to go over what to expect so you’ll get an overview of what’s going on. The pre-clinical program is divided in 8 weeks. The first 2 weeks has to do with preparations for the clinicals. The first week has to do with labs, which includes practicing injections in dummies, nasogastral tube insertion, catheter insertion, etc. The second week deals with EKG and orientation for the clinical. In this week there is no fixed schedule, you have to show up when the doctor shows up and the worst part is if you come to the hospital after an hour and a code yellow occurs then you have to leave and the orientation is cancelled, fun huh? It’s very frustrating and time consuming.

For the rest of the 6 weeks you will be split in groups for your rotations. The rotations include:

  1. OB/GYN
  2. Internal Medicine
  3. Family Medicine
  4. Surgery
  5. Pediatrics
  6. Psychiatry

Our On-Call schedule are as follows:
Internal Medicine – 2 Shifts
8 PM – 8 AM Weekdays
8 AM – 8 PM Weekends

Family Medicine
8 PM – 8 AM Weekdays

OB/GYN
8 AM – 8 PM Weekdays

Surgery
8 AM – 8 PM Weekdays

While doing the rotations you will also be assigned to do presentations on a topic classified within the rotation. Also during rotations you have to complete 2000+ questions from a desired QBank. It’s a lot of materials they throw at us and unfortunately they expect us to study well for USMLE Step 1 while being on this hardcore schedule. So, my advice for all those of you still in Bonaire and Anguilla, prepare yourself.