Dr. RW points to some student observations about IM. General internal medicine gets no love from medical students.
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internal medicine was the first clinical experience i had.
that said. i can say this…
the residents were lazy (one guy slept all day)… I only remember a few really sick patients who i learned from.. otherwise it was ROUNDING… and WRITING PAGELENGTH NOTES (really dont think that much detail was needed on a daily basis). SITTING in conference rooms at the worst times of the day. AND waiting until 10 am to get labs that we had to include in our already written notes. After having fun in surgery i never wanted to do IM.
not to mention that i got a complaint at the end of the rotation that I complained about “marginal” topics. yea i remember that. 10 weeks of work and unwelcoming comments. welcome to medicine.
Unfortunately for med students and patients alike, by the time one recognizes value in Internal Medicine it is too late to benefit from a good Internist.
By the time grandma’s had a stroke and her diabetes is uncontrolled, and she has mild renal insufficiency, etc. she will have had
1-CT/MRI/MRA – “several stenoses in blah blah blah and age-indeterminatere blah advise clinical correlation” etc.
2-carotid dopplers
3-renal ultrasound
4-echo, perhaps of the transesophageal variety
5-several lengthy subspecialty notes with limited advice but lots of rehashing of test results
A good internist is the one putting together the pieces, steering the patient toward the right course of treatment, and maintaining a long-term relationship with the patient.
How many times have you seen the ball dropped from nobody knowing the patient well enough?
“not to mention that i got a complaint at the end of the rotation that I complained about “marginal” topics. yea i remember that. 10 weeks of work and unwelcoming comments. welcome to medicine.”
This isn’t medicine…this is life. Hard work, frustration, spending too much time on tasks of dubious worth, lack of recognition…show me a job that doesn’t have these and I’ll start polishing my resume.
I am two years out from residency…first year in primary care and second year in hospital medicine. Now I am starting a fellowship in July. Good bye general internal medicine!
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