Fourth year has officially begun and my first clerkship of the year is emergency medicine. Since traditionally the first few clerkships of fourth year are dedicated to your field of choice, I keep encountering residents and attendings asking if I’m applying in emergency medicine. However, I am still committed to applying in family medicine! The trouble is, by the time I figured out I wanted to be a family physician, the family medicine acting internship clerkship was totally booked until nearly the end of the school year. So, I had to fill my schedule with other offerings and my mentors in family med suggested that emergency medicine was a good place to start since the field also deals with many primary care complaints.
I expected that emergency medicine would be challenging for me. During third year when I had to go on consults to see patients in the ED, I was not a big fan of the pace and frenetic, hive-like energy. I always felt like I was in the way, or that something terrible was about to happen right in front of me. Confronting these feelings has been my first hurdle in this clerkship. The immediacy of diagnosis and management is also stressful for me. I am often a bit indecisive, so practicing simulations of cardiac arrests and airway emergencies gets my heart rate up as I try to decide how to manage the situation. So far, though, only one cardiac arrest has rolled through the door while I’ve been working in the ED. I think I will need to see a few more before I feel ready to jump into the fray and help out.
I have enjoyed the chance to practice a few procedures during these last couple of weeks. I got to do a pelvic exam on one patient, which was cool because I’ve only done a few, and most of them have been on manikins or standardized patients. I think that I will want OB/Gyn to be part of my family medicine practice in the future, so I will definitely need to hone these skills. I was glad to get some practice! I also got to place an orogastric tube on a patient. I was a bit more nervous for this, since I had never tried it on a real patient before. The team assured me that I could not place it incorrectly since the patient was already intubated – there was only one place for the OG tube to go! That calmed my nerves and I successfully placed the OG tube, and heard the gurgle when they pushed air into it to check its position. It was a cool experience, and I’m glad my attending encouraged me to give it a try. It’s been a challenging couple of weeks, but they’ve flown by. Two more weeks of this clerkship and then I’ll be going home to work at camp for two weeks! I can’t wait!