I have got a few minutes to type this before i rush off for my piano lesson.
Internship has been a slow rumble along. I am learning more about drugs and how to be a good administrator and a personal assistant to the higher-ups as compared to learning about medicine.
The first week was pretty rough. It was all about learning to be confident, especially when i started getting paged by nurses, ward clerks and general practitioners, all wanting to know what i should do for this patient or that patient. I was worried of making any mistakes, so every tiniest detail i had to run past the senior doctor to whom i was attached to. The senior doctor is really nice – she was very patient and listened earnestly to my innumerable questions before giving me concise answers.
On the other hand, i was feeling very incompetent and very inefficient. I asked what drugs and their doses should i commit to memory and this is when i discovered that theory varies widely from reality – there is no algorithm. It all boils down to experience, to which i have zilch at the moment. So i can only pick up information from the patients under my wing. And sadly, for some reason, i don’t have a variety of patients. They all come in with exacerbation of COPD and heart failure. We either jack up the frusemide and start empirical iv antibiotics with no idea what we are treating (too often these patients have already seen their local doctors and have been prescribed oral antibiotics so most cultures are negative for growth) or we weigh them compulsively and obsess after their fluid restrictions.
Because i am in a smaller hospital, the workload seemed to be a little lesser (although i did ask friends in larger hospitals, and our doctor to patient ratio is roughly equivalent, so it may all be in my head). This is also my only General Medicine rotation (i have more surgical rotations, my preference), and i am just a tad frantic that i may not be learning as much internal medicine as i should be.
Anyway, i got to go now, more later!