Sunday, January 15, 2017

Update - Ambulatory Rotation

Well, I made it through pre-clerkship! After countless lectures, quizzes, TBLs, labs and exams, I am finally in my clerkship training period and interacting with patients. This is an exciting and refreshing change of pace. I'm starting out in ambulatory so I am at outpatient clinic sites. So far I have attended clinics in pediatrics, internal medicine, pediatric genetics, renal clinic, and diabetes clinic. I'll get experience with several other clinics too before the rotation ends. I knew that I would really enjoy clinic and interacting with patients but I didn't anticipate just how rewarding it would be to be able to participate in patient care on this level. I'm finding myself recharged after a long bout of the burnout from the pre-clerkship phase. It has only been 2 weeks but here is the rundown:
  • Wearing real clothing is weird and uncomfortable but it is growing on me.  My pre-clerkship period uniform consisted of sweat pants and my snoopy pajama pants.  I rarely dressed business casual. Now I have to do it every, single day. At first I was like, "$*@&"!!!! Now I'm getting used to it but still finding ways to make it comfortable.  I bought some grannie shoes from Clarks that I can wear all day and I'm incorporating my Mr. Rogers sweaters as often as possible to keep thinks less business and more functional. 
  • Pooping schedules are complicated.  I'm just going to throw this out there and be honest. When you reach a certain age your body needs a certain type of routine. Your system is more sensitive and adapting to intrusions on this routine becomes more difficult. It is something that no one worries about in the 20s and then, WHAM, suddenly you find yourself in the mid-30s and on a delicate schedule.  Most medical students are finished with residency and are well into their practice of medicine before this change. When you start late it is just one of many issues that suddenly becomes a daily dilemma.  
  • When you look and sound a little older, patients have more trust in what you say and do as a care provider. This can be good and bad. Patients are automatically more comfortable when they know that they are talking to someone who has had some real life experience. On the other hand, more trust comes with more expectations so I often feel like I should know more and have more skills than a person at my level of medical training.  It's a tough balance. 
  • My superiors are from a more familiar planet. I've really struggled to connect with my peers in med school.  It seems like they are from a different world at times; I'm a Gen Xer, they are Millennials. Beyond the obvious generational and maturity gaps, most of them are from an entirely different up bringing. Now that I'm in the clinics I find myself able to identify with my superiors but from this awkward position as a subordinate. They are the people who I would want to have as friends but can't. It is very awkward and makes me long for the time that I am in practice and surrounded by colleagues who are, at the very least, from my own generation. 
Okay, back to the books for me.  I'm currently trying to study for Step 1 as I go through this rotation in hopes of starting out my 6-week intensive study period having already finished the USMLE Qmax question bank. Hopefully I can pop in and share more as I go through this rotation. I'll definitely be sharing more about my Step prep too. Best, J.