The first week of internal medicine is complete. I didn’t think it went too badly, and I didn’t think I was very tired, until I laid in bed for a while with the plan to get up to workout soon, and ended up laying there past 9pm without any dinner, simply because I couldn’t get up.
This is a different kind of tired. I’ve never been given this much responsibility, and I’ve never been expected to learn so much, so quickly. I’m getting quite enough sleep at night, that’s not the issue. It’s just… a lot. Being handed a patient and actually being the primary care provider for them, plus or minus the big decisions made by the attending. Being accountable for being on top of their labs, their investigations, their abnormal values of any kind. Knowing everything about them–social situation, disposition planning, family life, financial situation… it’s a lot to know, and a lot to be responsible for.
It’s funny how they throw you in with very little understanding of what internal entails, but at the same time I don’t think I could read through any guideline or handbook and make sense of it. I had mentioned that as feedback for my preceptor today, just giving students an outline of the day or something, and he said it just wouldn’t work when no two preceptors are alike and no two wards are the same. So it’s just one of those things you have to learn by doing.
Even with my call shift on the very first day of service, even with getting horribly yelled at and embarrassed at a teaching session today, I don’t think I would trade this for the world. I doubt the medicine will get boring or repetitive on such an acute type of unit. In one short week I already feel like this is the most “doctory” I have felt, and probably will feel, out of all my rotations.The level of responsibility on internal med is an honour and a privilege, and also the best learning opportunity to make a few mistakes before really becoming your own. Though it’s hard work, and it’s probably not something I’d like to do forever, I acknowledge it is an inevitable and necessary and extremely helpful step in my career.