The other day, I was reflecting on how much we learn in just one year of medical school, and how much more I know now. I was in my preceptor clinic last week, and was flipping through my notes through the first few clinic visits. I laughed to see my note about how stiff neck and fever would raise alarms for meningitis, something that I did not know and my preceptor informed me was key to remember. To me, this seems like obvious knowledge now.
I also instantaneously correctly diagnosed a patient during that same visit. She presented with a dermatomal rash on her back and my preceptor asked me what I thought it was. I did not hesitate and responded, “Shingles,” seeing the hallmark rash and also after hearing the patient’s prior history to getting shingles. She also fit the epidemiological profile for a viral reactivation. My preceptor was impressed and asked me to explain the risk factors for reactivation, and treatment for the virus. I felt accomplished after this clinic visit, not just because I accurately diagnosed a patient, but because I feel much more confident in myself; both in physical exam skills, and medical knowledge. It is incredible how much you can learn in just one year, and also scary to think that after 1.5 years, you’ve theoretically learned all the foundation concepts and are “ready” for rotations. The contrast of being an M1 vs an M2 to me is very stark, and while I know there is still so much more for me to learn, I also feel not as intimidated and helpful in clinic.