Family Medicine: Intro

So family medicine. Its set up a bit different for students than for residents. So to start we have to talk legestics. There are two clinics that take 4 PGY-1s (first year residents aka interns), N clinic and G clinic.  So I spent thanksgiving week at the N clinic, it was extremely uneventful. I got thanksgiving off since the office is closed and I took my USMLE so I worked 2 days and one was full of didactic lectures. I saw maybe 4 patients total. It sucked. Apparently, FM has a big problem with getting patients to actually show up for their appointments.

I can say I had a pretty shitty intern who did not let me participate in patient care. He just had me follow him around and it sucked. I pretty much watched him blow off patients. Not to mention the clinic just switched from  paper charts to electronic records so the interns, most of whom are foreigners are struggling.

Actual situation:  68y.o. white male with Diabetes, in apparent distress.

pt: "My wife died last week and she was always the one who handled my blood sugars. I don't even know what number is a good number."

shitty intern: "Uh-huh. When you have last colonoscopy?"

pt: "Oh. I don't know, maybe last year or the year before. My wife, she kept track of that. Can you tell me what number is a good number for my blood sugar?"

shitty intern: "Uh-huh. We talk about that later. You have flu shot recently?"

And the situation went on as such. And we never addressed his diabetes, never explained what it was or what number was good. Although he did send him to a diabetic nutritionist who the patient can't afford. Handy right?

My second week was on inpatient FM.  We are there to take care of the 2 clinics' patients in the hospital. In the morning we are supposed to round on the patients and then we round with the doctors and then we sit in this room til 5 and wait for the ER to call with new admissions.

The first day I showed up at 7 as instructed and no residents showed up until 930. needless to say I was panicking. But apparently we did not have a single patient in the ER. That happened the second day too. I was getting pretty tired of it. Luckily toward the end of the week had a couple ER admits and 4 patients. So i got to see something, finally. But it wasn't anything of note.

All I can really explain is when we got to go to the ER, I was so relieved. I was like the ER!! Thank you GOD!  And after my shift ended I just chilled out in the ER and followed a resident I knew and saw a bunch of patients. I was like kidney stones, AWESOME!  Drug seekers, I MISSED you! it was so much better than FM. I saw twice the patients I saw in FM that day! Granted I only stayed for like 2 hours because I was tired (i mean i did work/sit around all day). I thought about staying until 10. Maybe I should have. I dunno. I got to meet several of the attendings tho and hopefully they will remember me later. I do feel dumb as a rock when I go in there tho. I don't know what tests to order next or what drug to prescribe and that is basically what you do in ER.

I just ended the inpatient week knowing that although its fun to get to know the residents, I'd rather be in the ER.