So I am currently on the inpatient portion of my pediatric rotation. I loved the outpatient portion. I was able to see patients, talk to patients, examine patients, etc. I am currently at a large teaching children’s hospital. Every morning our group of 2 interns, a senior intern, 3 medical students, an attending, fellow, nurse, social worker, nutritionist and whomever else decided to jump on the bandwagon goes around and talk about patients. This is why I don’t like inpatient medicine.
In my opinion the focus is not so much on the patient himself, but rather what problems he has, what medications he is taking, and what orders need to be placed. It is more of a logic game than taking care of patients. The day is spent writing notes, charting hospital courses, walking around the hospital and writing history and physical notes rather than talking to and examining patients. I know I never want to be treated at a teaching hospital. While the quality of care is high, I simply can not stomach having 12 people examine me by the bedside at 6 am. I have experienced this – being a patient in a teaching hospital and it was the most awkward experience I have ever had. I was forced to tell my story to about 9 people sitting around in a circle in some strange room. Not for me. I really like pediatrics, but the inpatient experience seems to have ruined it for me. I don’t understand, and never will, why all residences and internships have such a strong (i.e. exclusive) focus on hospital medicine. Even in family medicine, where the vast majority (if not all) residents and interns will work in a non-hospital setting, the majority of training is in hospital medicine. The same is true for internal medicine – even for residencies with so called “primary care tracks” the bulk of time is spent taking care of hospitalized patients. I simply don’t get it and honestly didn’t think this out when entering medicine. Sure the training is good, but if you don’t want to work in a hospital this is an awful amount of time to sacrifice working in a setting that brings you little joy (i.e. at least 5 years).
Most of the interns are younger than myself which is fine as long as they are nice. I recently had a super awkward interaction with one hat obviously had no idea how to interact with people. I asked her about a patient that was on our service and she snapped back with a contorted face “this is our patient”. Okay, first I was trying to be nice. Second you look 12. It was only after this interaction that I was warmed about this particular team and how medical students should not interact with them.
Call is also another shitty part of being a medical student. I am not going into a profession where I will have to work twice as many hours a week as the average person. Even with hour mandates, residents are capped at working 80 hours a week with no more than 30 hours in a row on call. I have done these overnight calls, and except for the bravado of being able to brag that you worked a 30 hour shift, there is no educational benefit of being at the hospital that long. I am going into primary care, because there is absolutely no way ever I will work an 80 hour week. Even the though of doing so in residency makes me want to vomit, but just one more hoop to jump through before I can finally work in a community clinic and have a somewhat normal life again. I love certain aspects of my training and learn a lot, but there are several things I can not stand.
Those who have never had a normal life outside of medicine and school can’t understand it – but medicine cannot be shoved down someone’s throat 24/7. Let’s take an example – I recently had a late evening call until 9pm (after arriving at 6 am) which was fine. However during the day there was a teaching session, followed by rounds (educational), followed by two more teaching sessions during the lunch hour. There is only so much education I can take. Never in working in the hospital have I had a lunch hour as they are always taken by lectures. All I ask is one hour free of medicine and duties to not have to think about medicine and not be in the hospital (i.e. leave if I want). Is that too much to ask? Isn’t this part of union’s such as SEIU push to have employees have breaks during the day? There came a point when my brain was tired and I didn’t want to hear anything about medicine anymore so I just shut down and stopped listening. I decided this was fine, since it was the only break I was going to get. I miss being able to eat lunch in a park with coworkers, maybe god forbid even go to a scheduled doctor’s appointment during the lunch hour. Nope, not on hospital medicine. You will shrivel up since you are never exposed to sunlight so you better take you Vitamin D. One poor intern told me she never sees light since shes been on night shift for two weeks and must make sure to take her vitamins. Sad. Well soon I will be out of all this ane be nonethewiser. And at least I’ll be damn good at writing a hospital progress note and eating nonnutrtive snacks such as candy and caffeine all day and night and evening and morning.
Tales from med school 