Finally LEARNING medicine

Up until this year, medical school has been a long series of arduous memorization tasks with the ultimate goal being passing an exam at the end of the course and moving onto the next exam and getting into the hospital. Then you get onto the wards and you're stuck trying to figure out how to write a note on one patient while your team has rounded on about 30 others. Slowly over a few days you figure out how to get things done and you get comfortable in that role...but then it's over and you're onto another service or specialty and essentially back to square one.

So much of third year of medical school has been an absolute waste of hours. It's incomprehensible to anyone that hasn't been through it that I could complete a total of 20 minutes of work in a day and do nothing else with the remainder. On surgery, I'd stand around in the OR holding a retractor for three hours staring at the back of someones shoulder because it was an interesting case just to spend 10 minutes writing an op note. I spent peds writing the same note on the same patient every day for a month straight. I've stood around for hours on rounds talking about the consistency of patient's stool, phlegm, nasal discharge and every other bodily fluid just because there's a teaching point burried beneath the pile of excrement. I've introduced myself to the same demented little old lady every day this week, and said goodbye as she begs me not to leave her...breaks my heart every time still. Today was the perfect example of medical educational inefficiency: 8AM-8PM Sunday call...I wrote 2 notes and one admission note, ate 2 meals, had 4 small cups of coffee and stood around watching my residents enter orders, answer pages and take admission histories for about 10 hours. Atleast my new team throws around some decent pimp questions that are clearly worded in English and logically extension from the discussion we were having on the patients...so I atleast feel less frustrated.

A funny thing is starting to happen though, something's starting to click. I'm able to answer a good portion of the pimp questions, I'm nailing down my treatment plans for alot of the more common ailments and I'm actually able to keep up with the majority of the discussions. Moreover, I feel like I can pick out and retain the pertinent parts of a history without forgetting anything too huge. I finally feel like I'm a part of the team rather than a lead weight dragging the whole process down. While I haven't really mastered my differentials, nor have I been allowed to see patients on my own, I feel like I'm getting to the point where I have a level of knowledge that allows me to eventually operate as a bumbling sub-intern.

Unfortunately, I'm going to be that bumbling sub-i running around the EDs of programs that I want to match in JULY...a mere 8 weeks away. Crap...this is all coming up waaaaay faster than I thought it would. Before you know it, I'm going to be Dr. Bostonian, PGY-1 EM resident...::gasp of horror::

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