Sub-Internship

I am doing a sub-internship in Internal Medicine where I am supposed to do what the intern does in preparation for my own intern year next year. So basically I do everything I normally do as a student but I have a fancier title. I also get asked a different set of questions than the 3rd year student. The 3rd year student might get asked the criteria for a diagnosis where I would get asked the specifics of managing it. 

I was expected to be accountable for all the patients I was seeing and to also know the plan for all the other patients on our team. This included knowing details from why we were treating an infection with a particular antibiotic including dosage changes to patient's urine output to the specific pathophysiology behind their medical issues. It is tough but nice to be held to a high standard.

This program is definitely heavy on the academics. We have 3 lectures almost every day - morning report, resident lecture, and student lecture (yay for free lunch). I only go to about half the student lectures since they are primarily for the third year students and my resident will have me working with her instead, especially when the intern is in clinic. We have a really cool group of students from Saba and Quinnipiac. Our student lectures are really interactive and we have lots of laughs but still lots of learning. 

We always say that the first 3 days are the worst because you are adjusting to so many things. Hospital. Apartment. People. Specialty. For me, this often means a 3 day headache and lots of advil. I thought this hospital, being affiliated with Yale and all, would be a bit fancier. It's all double rooms and old furniture. I’m also doing a lot of “scut work” which is usually administrative tasks (making follow up appointments, calling the lab, filling out sign out charts, etc). I always heard about this so-called “scut work” but honestly didn’t do a whole lot of it through my rotations so far. I guess I should consider myself lucky for that.

We were on call every 4th day which meant we would be admitting patients from the emergency department and we were respond to "codes". The code would either be a rapid response or a code blue. It was interesting to watch the residents in action during these emergency situations and makes me wonder how well I will do with them when it's my turn.

I only had 2 days off during the entire month (the Sunday of the first weekend and the Saturday of the third weekend) which left me very sleep deprived. There were days where I got back to the house at 9pm and knew I had to leave again at 5am the next day.

I can’t help but make comparisons between internal medicine here and internal medicine in Louisiana. I would say they are both good rotations and I am definitely glad to have had both experiences. It has been really great to see different hospitals in different sized cities all over the U.S. and I think it has helped me focus my efforts towards what I want out of the next 3-4 years of my life.

I love our little house that we are renting. It is basically an in-law suite that is a separate building from the main house on the property and it has everything we need (kitchen, laundry, etc) in a small one bedroom house. The property is all pool decks and garden flowers and kids laughing and the word LOVE on the side of the house. It is perfection.

My attending is extremely thorough and pushes our team to think through every step and process which is great for active learning but sometimes can get frustrating when I don't know all the answers to his questions. He is very mindful and challenges us to confront and address our biases before entering a patients room. I appreciate things like that but I can also acknowledge that it makes the process of rounding on our patients much longer for everyone so I try to keep my questions to only the most relevant. 

I enjoyed the dynamics between students, residents, and attendings at this hospital. I always felt supported and respected by the people I worked with and the faculty seemed very committed to patient care and medical education. I think that part of this is that there are only a small amount of students so we integrate more easily with the residents than if there was several of us per team/specialty. I think that this is a place that I could be happy.

We took the NAC OSCE which is the Canadian version of the exam where you interact with and manage fake patients. I found it to be more challenging than the American version but perhaps that is because I am trained in the American system. Update on this: I passed! (So did Craig.)