Friday, July 07, 2006

Specialty Medicine

I'm loving every minute of this beginning of our PGY-2 year, but there are a few things that are very different from prior experience in the medical field (medical school and internal medicine internship) that will take getting used to.

- We no longer work in a group (in internal medicine that used to be a whole slew of people including one resident, 1-2 interns, 1-2 medical students, possibly a fellow, and the attending); rather, we work one on one with attendings, and sometimes have a student around. It's a little strange to not have others around, partly for the social aspect, but also because you lose the sense of what you are supposed to know - whether or not you're performing at the expected level or whether or not your knowledge level is adequate...

- We get lectures on topics that we don't know, but they are spread out throughout the year, so there are diseases and medications that we are NOT familiar with. I guess that is similar to the jump from medical school to internship, but at least for that change we had 4 years of medical school "training" mainly geared towards internal medicine, so even if we weren't very familiar with the material we had at least heard of it, or knew exactly where to go to look things up. Now there are diagnoses that I'm not even sure I'm spelling correctly as I scramble to write down the term to look it up later. And there are a different set of medications that are commonly used...

- This is pretty much a completely new field for us. Most medical students are mainly taught internal medicine in school, so all of the specialty residents have to try to pick up a new field once they start specialty training. Which means you get through the day seeing patients, then have to read, read, and read some more when you get home. They say learning in medical school is like drinking from a fire hydrant - if so, this is the 2nd fire hydrant in medicine.

One encouraging thing - today a third year in our program was discussing a differential diagnosis with the attending and pulled out a whole bunch of diagnoses that sounded really foreign (and very cool), and it's good to think that in two years, maybe, just maybe, we might be in her shoes...


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