After two long years of preclinical education, and many weeks of studying for Step 1 and waiting for scores, the time has finally come to practice real medicine! My first real third year clerkship is family medicine. It’s been a great change from learning in the classroom. The pace is fast, with only twenty minutes per patient and little time to debrief after each case. For the first couple of days, I mostly shadowed the residents, following them around and appreciating their different styles. Once I became acquainted with the practice, the attendings and residents, and the EMR (a formidable opponent for sure!), I started seeing patients on my own. Of course, the resident or attending goes in and sees the patient after me, but it’s exciting to get the first crack at solving the problem or eliciting the full story.
I went into this clerkship thinking that it would be a good start to third year, providing me with a solid foundation in both clinical concepts and patient interactions. This has certainly been the case. I’ve found myself picking up quite a bit of information in a very natural way – through a bit of repetition and actually putting the information into practice! For example, in our initial orientation sessions for the family medicine clerkship, we were constantly told about the USPSTF (US Preventive Services Task Force) and their recommendations for preventive care at all ages. When this was being reviewed in the classroom, I found it somewhat tedious and seemingly arbitrary. However, now that I’m actually applying those guidelines in the clinic, I’m finding them easier to remember and much more useful. I’ve also been surprised at the variety of cases I’ve seen. At first, it felt like every patient had diabetes, hypertension, and depression. Certainly, those are common diagnoses, but there have been some odd cases that have kept my interest piqued. We had a patient with a monoclonal gammopathy, and another with a complicated case of hematuria. A proud moment for me was identifying a rash as pityriasis rosea! Although it’s not a rare condition by any means, I was pleased to be able to make the diagnosis myself. Seeing actual cases of things I had previously only seen in books has been rewarding – it feels like all the studying was worth it!
I’m about halfway through my family medicine rotation now, and although I still don’t think I would pursue it as my ultimate specialty choice, I’ve been pleasantly surprised by how much I’ve enjoyed it so far. We’ll see if I feel the same way about my next rotation…surgery. There’s so much to learn and experience in this year ahead and it feels great to get started!