Monday, February 29, 2016

Succeeding in the Internal Medicine Posting

Internal medicine (or general medicine for UK based medical programs) if considered one of the most important rotations in the clinical years. This is because in general, internal medicine provides the base for which all other specialties branch out from. It is to a students advantage to have a strong grasp of the fundamentals in internal medicine, and this can then be applied to other areas.

Tip #1: Use your time on the wards to the maximum.

It is a waste to use the time allocated to you for ward work to read books for example. There is plenty of time (well, maybe not plenty) to read books at home or the library.

Instead, see as many patients as you can. Take as many histories as you can. Examine as many patients as possible. Look at the medical charts. Use the viewing box to look at chest x-rays, CT scans, and other films available. Make friends with the nurses and the doctors. Volunteer to help take blood and put in IV lines. There's so much more fun stuff to do than reading books on the wards!

Tip #2: Work in pairs.

In the ideal world, it would be great to partner with another medical student whose opinion you respect and is roughly the same level as you. Take turns to do the history and examine the patient, one acting as the student and the other, the examiner. Give constructive feedback when you are the 'examiner' and give the best performance when you are the 'student'. It is so much more fun than working alone, plus, you have a second pair of eyes and brains to discuss the differential diagnosis and management plan with.

There may be instances that you or your partner are unwell, the remaining partner may chose to work alone or in groups of three. I still believe groups of three is a better choice than working alone because there is that sense of 'belonging' and 'helping each other out' when a medical student works in a group. There will come a time, maybe somewhere in the final year, that through hours upon hours of clinical experience, you will feel comfortable and confident enough to work alone. Still, I recommended spending 75-80% of your time working in pairs.

If you partner with someone who is way more stronger, you may learn a lot but this may also be confidence-shattering if the exams are around the corner. Vice versa, partnering with a person whose level is much lower than yours will make you feel like you know a lot, but you may not learn anything new from the experience.

So while it may be good to have many partners of different levels, advisable to work with one or two regular ones for most of the time.



to be continued

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