After finishing up on Morgan, I did two weeks on one of the six general medicine teams at the VA. I was the only medical student on this team. At first, I missed having a classmate to work beside, but I soon realized that being alone compelled me to answer more questions and interact more with the team; in addition, I was no longer as tempted to compare myself to others. I was also thankful for the slower pace of this service, as it allowed me to spend more time with patients and actually focus on learning instead of trying to get a set amount of work done.
The only things I don’t like about the VA are the lack of WiFi in the hospital and the medical record, CPRS. Because it’s only accessible at the VA, students have to stay at the hospital to finish the bulk of their notes, which typically makes for some late hours. Obtaining the proper access codes for the computers often takes weeks and can be a frustrating process as well. In an unexpected turn of events, I never got full access to CPRS, so I wrote very few notes while I was there (I promise I actually tried to get this fixed)! This added to the less hectic pace of the service.
The cases at the VA made up for the “zebras” I encountered on Morgan. During my time there, our team took care of several heart failure patients with symptoms of “volume overload” (leg swelling, rapid weight gain, shortness of breath), patients with liver disease who came in with jaundice, and patients with chest pain who required care under the Acute Coronary Syndrome protocol, which includes steps to manage heart attacks.
All told, I enjoyed the VA. While there, I began to realize that although I surely have much to learn, I know more than I think I do. Thanks to the encouragement of my patients and the residents I worked with, I started to feel confident about my ability to become a good doctor.