I got my first patient today. History of pretty severe brain damage coming in for some generalize weakness. He was also in a pretty well-guarded and kinda hidden ward. I got lost trying to find it when I left the workroom to pre-round on him. And when I did I kinda followed some people who looked like they knew what they were doing, and then had to ask around cause the patient was not where our list said he would be. When I finally did find him, I wasn’t able to get much info between the language barrier (even with an interpreter) and the cognitive impairment. Fortunately he did understand enough (I think) to let me do some physical exam so I wouldn’t come back completely empty handed, though also just watching him move (he was feeding himself at the time) did also give some good general exam findings that I could report on. After that the day pretty much business as usual. Rounding then charting. My guy was pretty stable so after a quick consult, we were able to discharge him. My note was in and I was done. First patient, in-and-out.
It’s definitely a lot different here compared to family medicine. A lot of people talk about how crazy IM is, but to me, even in peds, it kind of feels like there is a lot of downtime compared to family medicine, at least from a student perspective. In FM, I was constantly doing something. Constantly alternating between seeing patients, to charting, to seeing the next patient when they were ready. No time to catch a breath in between. That said it is still early, and I don’t have the patient load of an intern (or even a sub-I) so that def part of it (but similarly in FM I didn’t have a full load). Yet why does it feel like there so much less time in the day?
nANIMOv 