Working six days a week for the past month and a half on my internal medicine rotation has definitely tested my stamina and yet despite the constant state of fatigue, I feel like I have learned the most on this rotation. Weekend errands, household chores, and meal prep for the week have been crammed into my single day off. Moreover, how I hit the books given the long hours has changed with a focus more so on questions than on textbook reading, even though I do try to fit that in on the weekend day that I have. Here are some tips that I’ve picked up thus far:
1. Using time wisely during the course of the regular workday: I get in pretty early to preround, see my patients, and prepare my oral presentations for rounds. But other than that, my afternoons for the most part are pretty fluid, allowing me to go to various conferences, check up on my patients periodically, observe procedures, help with obtaining records and calling for different patient care services, learn at resident/attending teaching sessions, and most importantly, read and do questions. Even when I’m waiting for a lecture to start or if I’m sitting in the team room waiting on a fax or a phone call, I do a question or two and read up on a topic in Pocket Medicine or UptoDate.
2. Using my patients’ conditions as a stepping point for my reading: Attendings and residents are always giving the most generalized feedback comment of the year: read as much as you can about your patients. But, what do I read?! There are so many things to pick from: Step Up to Medicine, UptoDate, Pocket Medicine, Harrison’s, original primary literature, etc. Although it’s still slightly overwhelming to work up new patients who are admitted from the emergency department, I find that by reading up about each of the patient’s problems in a general source like the Annals of Internal Medicine or American Family Physician and then using ClinicalKey, UptoDate, or Pocket Medicine to figure out management and treatment pearls to include in my assessment and plan has helped me tremendously. And, the things I read about stick more in my small brain when I see it reiterated in my real-life patients.
3. Sleep: This one is probably the most important out of them all, but I admit that I haven’t been following through with it as much as I should. There is just so much to do at all times! Nevertheless, my lack of sleep catches up to me and I end up losing even more time, so getting enough sleep has been a work in progress for me.