It’s one thing to do a doctor’s work but it’s another thing when you diagnose something right without the doctor looking over your shoulders. Yesterday, the doctor sent me to do a full check up of a new admission on a female patient with a past medical history of hypertension and asthma. When I did a full check up I heard something abnormal while listening to her heart. I thought I was wrong but then I figured that I may not get the diagnosis right but I was confident her heart sound wasn’t normal. I went to my attending doctor and I suggested that she had a systolic murmur based on what I heard and also based on her past medical history of having hypertension. The attending doctor came in and listened to her as well and he confirmed that it was a systolic murmur also. He ordered an echocardiogram to see the intensity of the murmur.
Reading about it and answering these clinical questions correctly seems like a burden to pass the board exams; however, when diagnosing a patient with a real illness it feels exciting. Now don’t get me wrong, I don’t feel good about the patient having the illness but it’s a satisfying feeling figuring out the specific murmur out of the so many murmurs.
For those who are still studying for the USMLE Step 1, this is just the beginning of what you are studying for. Make sure you study well and know the clinical scenario for each diseases because you may run into such when you start your clinical rotations.
So what’s been happening with clinical rotations? Well, I’ll tell you; it’s not as bad as studying for the USMLE Step 1. The schedule I get depends on the attending doctor that we are under. Every rotation has a certain schedule, which is based on when and where the attending doctor show up or where he/she sends you.
For example, I did a Pediatric elective rotation and I showed up at three different clinics and a hospital. This rotation is off site from Jackson Park Hospital (JPH) so I never stepped into JPH until I started my core rotations.
The rotations are not that bad; however, it was difficult for the transition, from studying in a closed room for months to working with people in a big city. I have not interacted with different people for a long time since I was locked up studying for the USMLE Step 1 and the first month of rotations was hard while I adjusted.
Basically I do check up on the patients and report any findings to the attending or the physician assistant. The workload is not that much as it’s basically conducting what the doctor is supposed to do but their work in us. The workload includes doing a physical check up and doing SOAP notes on paper or on the computer, which depends on the facility. The attending doctor just walks in the room after I do my work and speaks to the patient and overlooks my work and corrects any error and signs off our work; this entire process takes about 30 minutes. I spend majority of the time in the exam room as I conduct the work and the doctor takes only 5 minutes to do his part.
This is where things are not so pleasing. Unless you can manage your time, studying while conducting rotations is kind of hard. If I come home at 5 in the evening then I’m tired and if I don’t have anything to eat then I have to cook so that takes more time. So at the end of the day I’m only left with 2-3 hours of study before I need to go to sleep because you need to be awake and focused to work the next day.