Internal medicine: week 1

Well the first week of internal medicine has come and gone, and I definitely love the confidence and learning that comes with being in clinic full-time. I have seen somewhere around 50 patients, and made 2x as many phone calls to follow up to others. Internal medicine is, if anything, an exercise in keeping the details straight, because most of the adults we see are very medically complex in nature. When I open a chart, I'm no longer surprised to see a history of heart issues coupled with diabetes, hypertension, cancer, psychiatric issues, and allergies to 12 different medications (thank goodness there are so many options, otherwise it would be very difficult to write any prescriptions for some of these people). Actually, I'm more surprised when I'm handed a relatively thin chart, or when the sticker plastered on the front says "NKDA," indicating that they have no drug allergies. I sometimes do a little happy dance in my head when I see that. But, I'm also discovering that it's the really medically complex patients that I learn the most from. I know which other drugs to avoid in allergies to a certain class of medications, resources to give patients, and where to go next when things would seem to get stuck at the fork on the yellow brick road just last year when I was a student in the didactic portion of my training. I'm very happy I had internal medicine as my first rotation, as I am able to use all of the information I've learned while it's still fresh in my mind. I also realize that time goes inexplicably quickly. I only have 12 more days left of IM, before moving onto plastic/reconstructive surgery. Stay tuned for the travails of week 2!