We finished up Internal Medicine by spending several half-days in clinic over the course of about 2 weeks. The clerkship director described this as the “diastolic phase” of the rotation to complement the pressure of the “systolic phase” of the inpatient services.
Each student was assigned to work with a few attendings in several subspecialties. We weren’t evaluated for these two weeks, so it really gave us a chance to learn about common reasons for outpatient visits and see examples of ways that a clinic could be run. The attendings had differing expectations for us medical students; some wanted us to see patients independently, others wanted us to simply shadow them.
I was assigned to work with two attendings: one in primary care and one in endocrinology. They had completely different approaches to my role in clinic; the former suggested that I see particular patients independently (for new visits, hypertension followups, acute complaints of cough, etc) while she saw others and had me write one brief note each day that I worked with her, while the latter had me simply observe him in each patient room while we saw patients coming for workup of potential thyroid dysfunction, maintenance of poorly controlled diabetes, and other chief complaints.
I kept fairly busy outside of clinic as well. Throughout the week before the shelf exam, third years were required to take part in a 6- or 7-hour in-person and online assessment of our progress with topics from various specialties. We saw a total of 6 standardized patients, with chief complaints dealing with each specialty, received feedback for our encounters, and took a basic science test online afterward. It was an exhausting experience, but it was really cool to see how our 9 months on the wards had allowed us to perform better in these sessions than we had in the much less thorough ones we were required to do during our first year.
On the same day as my scheduled assessment event, we got a small group together to participate in the National White Coat Die-In, a “black lives matter” demonstration organized and supported by medical students across the nation in light of the events surrounding the deaths of Michael Brown in Missouri and Eric Garner in New York, as well as other unarmed black men who have been killed by police in the recent past. We had a small turnout due to our decision to participate at the last minute, but we were all proud to be a part of a movement like this.
A few days later, I joined a few classmates for a free aerial silks class at a local fitness venue. I was pretty horrible at it due to fear of flipping upside down and/or falling and hurting myself, but I was able to strike a few poses. My entire upper body was sore for days afterward–in fact, I still can’t lift my arms all the way above my head a full week later! I’m on the fence about whether I’ll take more silks classes and work on overcoming my fears, but a classmate and I are considering showing up for a few pole dancing classes at the same facility, just for kicks.