Thursday, March 5, 2020

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Yomi Adeyemi, Student doctor Family Medicine

I've been a bit busy lately so this one's a little late, but here it is; Family Medicine. More than any other specialty, this one encapsulates the kind of work that I think most people have in mind when they think about "their doctor". These are the docs that you see for regular checkups, and who refer you to specialists when necessary. They're also the docs that can take care of you during a hospitalization, help you deliver a baby, and even take care of children. In some rural areas, family docs may even be the only docs available. The scope of practice is impressive, and it really appeals to me.

This particular family medicine rotation is on the inpatient service. That means I'm spending four weeks doing hospital based work, which actually makes this rotation a lot like my internal medicine rotation. 

Here's a typical week in my schedule:



The schedule is simple; two nights then a day off (I spent this week's day off doing an all-day Kaplan prep course for my upcoming USMLE Step 2 CS exam), then six days. Two of the days are "rounds" which are a bit shorter. The schedule then repeats. Thats it

The family medicine inpatient service at my hospital is divided into 5 teams. Generally each team takes turns bringing on new admits during day shifts, and one team takes patients during night shifts. If a patient has been followed for visits outside the hospital by a particular Resident, that patient is admitted onto the Resident's team to have "continuity care" with the doctor they are already familiar with.

Nights

Students show up at 8pm for sign out from the day teams. After sign out, we see patients on team(s) we are covering for the next day for their day off, in addition to any patients assigned to our team. During a night shift we take new admits from the ED. In the morning we then round on patients with an attending physician, and sign out our patients to the day teams. Students are usually let go by 10am. Rinse and repeat for a second night.

Days

Morning pre-rounds start at 8am. Students are expected to continue following any patients we admitted on a night shift or previous day. This is where students looking to make a good impression can show their knowledge by coming up with great plans of care, and giving brief clinical presentations on aspects of patient's diagnoses or management. Rounds with our attending physician are usually concluded by 12pm. afternoons are spent writing discharge summaries for patients who a re leaving, and getting follow up appointments scheduled for these patients as well. Day teams also take turns getting new admits from the ED. By 5pm days are done, and I head home for shelf/step study.

Rounds

These are short days. We still start at 8am with pre-rounds then round with an attending until about 12pm, but we aren't expected to take on new admits, so after tasks needed for patients getting discharged are done, we head home.


Final Thoughts

I'm coming toward the close of my third year of medical school, and it has been quite the journey. The experiences I've had this year have at times been totally unexpected. I've had highs and lows along with my fellow med students, and through it all I've really begun to understand what I want out of a career in medicine. When I was young, I was always that kid who said I wanted to be a doctor when I grew up. My idea of what a doctor did was pretty much what I now know falls under family practice. In the years since then, especially during college and graduate school, I'd really gravitated toward the surgical subspecialties and I thought I'd go into general surgery. My rotation experiences have really changed things though, and in a way my feelings have come full circle. I want to become that doctor I had in mind as a young boy. The doc that patient's trust with their regular care. The doc that can take care of the patient from birth to old age. The family doc.

I'll have to wait till August for my outpatient family medicine rotation in my 4th year, and I'll of course be keeping my mind open for that experience. At this point though, I'm pretty sure that this is the specialty for me. If you'd like to see these moments captured day-to-day, check out my pages on Instagram or Facebook.


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