Wednesday, July 31, 2019

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Abayomi Adeyemi

One of the questions I get asked most frequently by pre-meds (right after they ask about the MCAT) is what exactly life is like as a medical student??? Well, I've decided to write this post for you, young pre-med, and for anyone else interested in what the schedule of a medical student looks like.

As a third year medical student, I've been through 2 years of basic science studies (a bonding experience between you, cadavers, textbooks, and countless exams), I've also cleared the gauntlet of USMLE Step 1 study and passed the exam (thank God) before being certified to start clinical rotations. If you're not familiar, clinical rotations are where a medical student finally gets to actually work in the hospital day-to-day. Every medical school has a set of required "core rotations" that students are expected to complete during their third year. These include Internal Medicine, Family Medicine, Pediatrics and OB/Gyn, Psychiatry, Emergency Medicine, and Surgery for most students. Basically, third year is a grand tour through a wide swath of medical specialties, during which students are expected to learn the ropes of practical patient care and management, and (hopefully) find which specialty makes their hearts feel all warm and fuzzy and which they therefore intend to pursue in their career.

This is my first core rotation; 3 Months in Internal Medicine, "the thinking man's specialty" 

Monday, Thursday, Friday

These are my "regular days" for this particular week; I wake up at 5:30 am, shake out the cobwebs, make some coffee and bike over to the hospital.

To start the workday, I meet up with my fellow med students and the residents whom we work under. Each medical student then picks 2-3 patients from our team's patient list whom we intend to review records, see in person for a history and physical, and write up a progress note for them. At Morning Report, we present our patient's cases to the attending physician (the head honcho doctor) whom then proceeds to rip us a new one (just kidding...kind of) and teach us the best practices to use for our patients as well as the fine details of clinical diagnostic medicine.

After reports, our team quickly "runs the list" a rapid fire process wherein the residents quickly go through our entire list of patients (sometimes up to 30-40 people) and review what each patient needs done for the day. As medical students, we have to listen closely for tasks that fall under our responsibilities (These could be as enjoyable as following up with a patients case manager, to requesting patient records from other facilities, and perhaps even performing rectal exams!).

Next come patient rounds; as a team we are led by our attending to each patient room, where the chief resident leads an interaction with the patient and the attending answers any questions and points out valuable teaching points for residents and students. This is our opportunity as students to observe how an experienced physician handles our cases.

By noon, students report to the internal medicine daily conference. This is where IM residents present interesting and unique cases in front of the entire IM department. You'll notice that this is also the time that normal people eat lunch, and it is for us as well. Usually the conference room has got food set up, and we medical students either try to grab something after the residents have their fill, or bring our own food to quickly wolf down.

After the conference is dismissed, the medical students regroup and divvy up the various tasks that we were given during our run of the list earlier. Residents typically add requests as the afternoon goes on (we've got a whats app group that stays popping with orders and requests from residents)

If I'm lucky, I get out of the hospital around 3-4pm, and from there, I bike over to the Gym. Chuze Fitness has great facilities and I get that workout in at least 4 days a week.

After hitting the gym I bike home, hop in the shower, and settle in with a bottle of Gatorade and My Microsoft Surface Pro tuned in to OnlineMedEd, Amboss, and UWorld Internal Medicine STEP 2 CK QBank. I've got a daily study schedule that I try to stick to, and by the end of the night my goal is to be able to comfortably answer UWorld questions on that day's topics.

After that it's crash and burn in bed

Tuesday-Wednesday, Saturday-Sunday

These are the tough days. I'm on whats called a "Q4 Call schedule", meaning every 4 days I have call duty. This means that instead of coming into the hospital in the morning, I'm expected to report in at 2:30 pm and remain in the hospital until 7 am the next day (this is what we signed up for folks). I typically hit up at least a couple hours of UWorld before heading over to the hospital. Once there, things usually don't start picking up for an hour or so, and I might be able to get in a bit more study. On call nights, our team in responsible for every patient currently admitted to the IM wards. In addition, we're responsible for admitting all patients from the emergency department into IM. This is where the bulk of the work for students comes in. We all hang out in a conference room, and the ED phones in new admits whom we must go down and see, get a full history and physical exam, and write a note for their chart including differentials and plans for treatment. These are then reviewed by residents whom we "chief" or present each patient case to.

The things we see and hear on these nights can be eye opening, which is lucky because normally staying up for 17 hours can tend to be eye closing.... The next morning our well rested colleagues return, and we help our residents as they "chief" their cases to the attending, and/or transfer patients to other residents.

You can see that I have "sleep" scheduled for the afternoons following these calls nights, and believe me, it is a very important item on that schedule.

This is my life now

Basically that's it. The schedule I've outlined here will be steady-state for the next 4  weeks at which point I'll switch to a new IM team with a different attending physician who may or may not dictate a similar schedule. I have 3 team assignments for IM rotation, 4 weeks each, totaling 12 weeks for my IM core. This schedule may seem dense, but believe it or not, I'm having the time of my life.

Hit me up on Instagram or Facebook if you have any questions, comments or post requests, and be on the lookout for my next article breaking down my Surgery Core schedule.




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