Family medicine – checkpoint reached!

I’m now officially halfway through my urban family medicine rotation, which is odd to see written down.  It’s been a wild two weeks, hard to believe it went by so fast.  In that time, my computer has been dead, raised from said dead status, cleaned out, transferred, and dumped unceremoniously on my couch.  My tablet and I have resumed our love/hate relationship.  I’ve considered applying for a loyalty program with Samsung now that I own one of their phones, tablets, and laptops.  I’ve worn shorts one day and warm trench coats the next.  I’ve seen two very excellent episodes of Doctor Who.  I’ve geeked out over receiving the September issue of Empire in the mail (oooh, the Hobbity glory of it).

Oh.  And I think I learned some stuff in there, too.

Let’s talk about that.

I’ve been lucky enough to have a lovely preceptor who not only enjoys teaching, but also insists on it being done well.  She was more than happy to let me see patients on my own, even some of the ones she dubs “interesting” and/or “difficult.”  Plus she loves Merlin and Lord of the Rings.  We get on pretty famously, I think.

Instead of your typical pro/con list, I thought I’d have a go at summing up these two weeks a little differently.  Everyone has certain expectations of a rotation in terms of what they’ll see, how much work they’ll do, and what they’ll learn.  The fun part is where you get to be surprised.  So here’s what did (and didn’t) surprise me so far:

Not surprisingly…

  • Everybody has high blood pressure
  • Everybody has diabetes of some variety
  • Everybody has an answer to, “Is there anything else you wanted to talk about?”
  • People’s bodies are quirky.  Lots of shoulder shrugging and “It’s fine” in family med
  • The diagnostic process for MS is exceptionally tough and long
  • Newborns make the best faces
  • Way more people are treated for depression than I thought
  • Every child seems to get Strep about 2 gazillion times before they turn 18
  • Most patients are lovely people who smile a lot
  • The Babinski reflex is a great way to find out what someone’s girly giggle sounds like
  • Some moms love their kids so much, it makes your heart ache

But to my surprise…

  • You can make amazing, rare diagnoses in primary care
  • I’m actually capable of making that crazy diagnosis
  • Some physicians are absolutely, ridiculously juvenile
  • Doing a physical with 3 kids under 5 in the room is nearly undoable, even for someone who’s done several of them
  • Textbook presentation of [insert any illness here] is super rare
  • Patients can make even well-versed doctors cry
  • The family med schedule is not cushy.  10 hour days, almost every day
  • Paps are nowhere near as easy as they sound
  • I cry a little inside when someone comes in with a history of coughing or fatigue or sore throat
  • Prescription refills are a great opportunity to chat with patients about fun stuff
  • Despite the little hardships and tough days, I love family med more than ever

Again, sorry about the delay for this post, hard to write when I’m without a laptop.  Hope everyone’s enjoyed their first two weeks in the semi-real world – keep truckin’!

 – Atalanta

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2 Comments

Filed under Medicine, Personal & Blogs

2 responses to “Family medicine – checkpoint reached!

  1. Yup, family medicine is a little bit of everything. I can relate to a lot of the things you mentioned. Even when people come in for a prescription refill, I always start the visit by asking, “What’s brought you in today?” Often there will be 4 or 5 problems in addition to the prescription refill! And, indeed, Paps are difficult and there are a lot of situations that “don’t read the textbook”. I remember once, I was in a rotation with a family NP and we had a young lady who was about 3 months postpartum. She had had a Depo shot about 1 month ago and had been bleeding constantly. My preceptor said that this sometimes happens with Depo. I said I’d like to do an ultrasound, so my preceptor said, “Okay, well, I wouldn’t do one yet, but you can do one if you want to.” I ordered one, and voila! The following week I wrote the referral letter for her to have a D&C – retained products! Score one for the student! I’m glad you enjoyed your rotation, though – family practitioners are often the first point of care for patients and it is CRITICAL that you know how to pick up on the little things and figure out when they’re beyond your expertise.

  2. Glad to hear that your family med rotation is going so well! You seem to be stumbling on a number of truths that don’t make it into the textbooks… I’m particularly fond of “The Babinski reflex is a great way to find out what someone’s girly giggle sounds like.” 🙂

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