Rotation 6: Family Medicine

I purposely scheduled Family Medicine as my last rotation for a few reasons. I definitely did not want to have anything "intense" as my last rotation, aka no Surgery or IM. I also had heard that Family is a myriad of IM, Peds, and Ob/Gyn and I wanted to have already had those rotations so that I could better understand Family Med, especially since it's an outpatient rotation and you don't have too much time to come up with diagnoses and plans. I also figured it would reinforce everything I had learned so far, and be a good review before starting Step 2 CK studying (more on that later...).

I was in a Kaiser setting during my rotation, which marked my 4th (!!) time working at KP - the others being during Peds outpatient, half of IM, and Gyn/Onc. I like the Kaiser system just fine. I used to be a KP patient back in the day and everything was incredibly easy to schedule, access, and cheap! The KP FM docs I worked with were really great. And they make a point of talking to you about career plans, offering advice about where to go, the pros and cons of different systems, etc. That was really refreshing.

Surprisingly (sort of?), the hardest part of the rotation was removing ingrown toenails! I know I'm not a procedure-friendly person, but I usually have no problems with blood or goriness. Open heart surgeries did not phase me, suturing up lacerations in the ER did not phase, but this was something else! Actually, watching it was much worse than me actually performing it. I guess when I'm the one removing the nail, I'm focused on what's going on, what to do next, etc., so it takes my mind off of what is really happening. But if I never have to remove another ingrown nail for the rest of my life, I'd be okay with that. Ha!

The weekend after the shelf also coincided with Easter, so I flew home for some much needed time off.

Yes, those are chux. Made clean-up a cinch.

And guess what?! That was my LAST SHELF EVER! 3rd year flew by so fast! Yes, I technically have one more month left, but it's my elective block, so it doesn't really count as 3rd year! I cannot believe it. Sometimes I think it was the hardest, most grueling year ever. Other times, I think it wasn't so bad, and I truly did enjoy it. It's remarkable how far you can come in just under 1 year. I used to be terrified of starting 3rd year, because as a career student it's easy to get used to the classroom environment. You are in control, you know your schedule and what's expected of you, and you do it. I wasn't sure how to handle the pressures of 3rd year, not knowing what's expected of you, or having different expectations from different attendings. I didn't know how I could learn what is needed or expected to be known without having a set syllabus or curriculum to guide me. But you know what? You take charge of your learning, you research the available resources, choose what's best for you, and set your own curriculum plan. And you truly do learn so much just from your patients and reading up on what's going on. UpToDate and Wikipedia are still my BFFs though, let's be real.

Rotation 4: Internal Medicine

Oh IM. Both a blessing and a curse. Universally known to be one of the more intense rotations, both in terms of hours, caseload, complexity, you name it. I worked incredibly hard during these 8 weeks, and learned an incredible amount. And I think I came very far, even achieving one of my goals which was to present (mostly) from memory during rounds. Win!

I really really liked the intellectual challenges and the way I was pushed during this rotation. I totally believe in tough love. But did I love the rotation? I'm not so sure. It was my last rotation before the holidays and I was thinking I might have been burned out (was literally counting down to vacation, like I had a countdown on my whiteboard which I updated on the daily !!), but then again I wasn't waking up every morning excited like I had been on some other rotations (cough, Peds, cough). You could say we had an "I love you but I'm not in love with you" type of relationship.

The most striking moment for me was that I lost my very first patient on this rotation. Sure, patients had died before, but they hadn't been patients I had been *directly* caring for. This was hard. I started taking care of her as soon as she was admitted. Seeing her getting weaker and weaker as the days went by was hard in itself, especially when she kept conveying how uncomfortable it was. We had many conversations with the family, and it was hard seeing how everyone was in a different place regarding accepting her condition. I was so impressed by how my senior resident led those meetings. Death and dying is definitely something I struggle with. I hope I can be even moderately as good as he was handling those discussions. And just like that, by the end of the week she was gone. I was actually watching the monitor as it flatlined. Her family surrounded her and everyone was crying. That was so hard for me to see too. I had to excuse myself to the bathroom and cry in there for some time. It was an experience and I hope I'm stronger for it.

This beauty had case discussion with us students every Wednesday morning. MD stands for Medical Dog-tor. Ha!

Appropriate. Also it was Halloween.

Finagled a 36-hour trip home for Thanksgiving to see all these kiddos! Promptly got sick for 2 weeks afterwards. So worth it.

Running into classmates in the cafeteria. Yes, there is a pizza slice in there. Somewhere.

After my IM shelf, I was blessed with Winter Break. Like 2 whole weeks off?!? With the prospect that I had maybe only 2 more weekends to work during the 3rd year because I so smartly front-loaded my schedule? It's like Christmas morning! Literally.

Med school friend A and I drove down home (well, he drove. I annoyed him). We talked. We sang 90s songs. We stopped by Merced to check out the Hmong New Year Festival. Cool stuff.

Hmong Festival food. If only I could remember the names of these.

Annual Christmas brunch with the high school BFFs.

OMG it snowed in LA! JK.

Peace out, IM. It was real.