So right now i am on my Internal Medicine rotation and overall it is very chill right now. Basically I go in to the doctor’s office at 8 a.m. and I see patients until 12 noon. Then I go for lunch and in the afternoon to medical specialty clinics. Like on Monday, after lunch, I was sent to work in a Gastroenterologist’s office and my experience was pretty great. Since I am only there for about 4 hours, I usually don’t get to see patients myself, but it is still good to see what a medical specialist does. In the Gastroenterologist’s office we basically saw patients who had chronic diarrhea and abdominal pain. What I enjoyed about it is that we had to really visualize and think about the anatomy of the abdomen. Learning the anatomy of the abdomen was one of my favorite activities during my 1st year of medical school.
On Tuesday, I flipped the switched and went into the GI Lab where they employ 8 foot long scopes to visualize people’s stomach, small intestines and colon. Getting to be a GI doc is really really hard; first you have to match into Internal Medicine which counts me out anyway because I couldn’t deal 3 years of Eternal rounding. But to get into a GI fellowship you have to basically kill of all your boards while in residency and you have to have extensive research with a well known GI doc. Even then there just aren’t enough spots so you may not make it in. But once you finish your fellowship the money truly starts to flow and if you sell your soul and decide to just screen colons all day for cancer you could rake in almost $1,000,000/year. Aside from how well it pays, seeing the procedures was actually pretty cool partly because I like the abdomen anatomy. The coolest procedure I saw was in a girl with Down’s Syndrome who had a pyloric stricture causing her food to sit in her stomach for very long periods of time So basically they fed a very long scope down her throat and into her stomach. Then they had to twist and turn the tip of the scope until they found the stricture in the pylorus. Once they found it they shoved the scope into the stricture and then fed a balloon down the scope into the middle of the stricture. From there they filled the balloon up with water or saline which stretched the stricture open (and caused alot of bleeding but that was normal). After they were done the stricture was definitely better and they would have to repeat it in a couple of weeks to stretch it to a more respectable size. If you have a medicine mindset but you really like procedures I could see how GI would entice you. I enjoyed watching but I think I would need to do more than scopes all of my life in order to enjoy it.
Lately I have really been trying to decide whether Orthopedics is really for me so last night from 6 p.m. to midnight I went on call with the team. I was with a PGY-2 resident and a 4th year medical students on his Sub-I. I had the option of watching a surgery but I really wanted to see what their life was like and man was it busy. They just kept getting hammered with consults from the ED all night. And I realized what makes a student on his sub-I a rockstar; if you can take care of the consults it makes your resident’s life 10x better and they will evaluate you very positively. I got the chance to put on a split and before I went home I did one consult myself. Overall I enjoyed my experience although I’m still not sure whether I enjoy just managing my patient’s bone problems or also their AST/ALT levels or their K+ levels. When I wrote these lab values on my consult my resident told me that they were bone docs, and if the lab or scan is not directly connected to the bone then you should not include it; he said that for that stuff they would just consult to the Internal Medicine guys.
About 5 people in my class had to get pulled off of the wards because they failed Step I. I honestly feel so bad for them because I know it has to be a terrible experience. Besides that though the Dean’s Office said that our class average was quite high so that is promising. This weekend I am going to the National Medical Association conference because there is a submeeting where a bunch of prominent minority orthopods meet. I really want to start making connections and the meeting is in Vegas, so I decided to go. I’ll see how everything turns out.
Man, I can not wait to get this type of experience in medical school. I took the mcat exam earlier this month and will be applying this year. Yo, J hold me down in your prayers.