Friday, May 09, 2008

Under the Influence

my co-resident Jill during teaching rounds with her students

Up to my 4th year of medical school, I was going to be a after I graduated. Since I'd always enjoyed kids, I thought becoming a kid doctor would be a great way to spend the rest of my productive life.

Then I realized that liking children does not translate to liking treating sick children - it cut me up too much emotionally. Also that practicing pediatrics involved a lot of mathematics - medication doses, ET sizes, IV fluids were always based on weight - which I abhorred. Besides that, children and infants were notoriously difficult to line.

And, most importantly, I fell in love with .

IM had always lurked in the periphery of my choices ever since we had our first lectures on it in 2nd year. As far as I was concerned, it was the subject that first introduced me to Real Medicine. The thought process of arriving at a diagnosis appealed to my inner nerd immensely. I enjoyed our 10 weeks of lectures in 3rd year despite the weekly Monday exams that completely negated our weekends for the duration. Our internist attendings never failed to amaze me with their clinical acumen whenever they would take us for bedside preceptorials.

But whenever people ask me why I decided to make it my specialty, my answer is always the same - because of my 8-week clerkship rotation in Internal Medicine.

Thankfully, I am a product of an era in medical education when intimidation and "terror tactics" at the bedside are no longer the norm. While my classmates and I faced the dreaded "morning endorsements" with a great deal of caution and respect, the senior residents who conducted them were more focused on milking each case for clinical pearls for the students' benefit than humiliating whoever was in front at the time. They taught us practical points on how to take a clinical history, what to ask, and even practiced us in the skill of arriving at a diagnosis.

I was lucky enough to have been assigned to residents who picked up on my interest and really took the time to teach. My senior resident in the wards would even ask me to research about patients under our care to help solve in dilemmas in their management. As a medical student, it was the first time I had ever been given any serious responsibility for any patient and the first time I felt I was really part of the medical team.

My clerkship experience gave me a pretty good glimpse of what working as an internist would be like, and, on top of the strong leanings of my inner nerd, clinched the choice for me two years later.

In a field where one of the cornerstones of education is "See one, do one, teach one," medical doctors at all levels in their training are obliged to teach. But, as anyone who has ever trained in a teaching hospital can attest to, this is a lot easier said than done - something I have grown to appreciate even more after having gone through residency myself.

I recently saw these seniors of mine at the convention just this past week. They've all started practices in different specialties and are now scattered across the country. I always enjoy seeing them again and updating them on my progress. From being once their high-strung clerk, I am now an internist in my own right - but they will always be my seniors.

During these once-a-year encounters, I let them know, tongue-in-cheek, that I blame them for getting me into internal medicine. Still, no matter how disgruntled I pretend to sound about it, they all know otherwise.

This is a submission to TBR-9 - Mentors, Tormentors - at Megamom's site.

(As a related post-script, Megamom was actually one of my Microbiology teachers when we were in medical school - and one of my classmates' favorites because of her clear lecturing skills and very practical examination questions. :))


Manggy said...

Hi Ma'am! Haha, I am SO trying to picture you as the high-strung clerk.. :) I didn't know that you and MegaMom were connected! That is fantastic.

I dunno about the morning endorsements... I never felt like the seniors were out to "get" me, but one way or another, I often feel completely blindsided by certain aspects of the case they choose to focus on! Oh well, it's all 'bout the learnin'!

dr_clairebear said...

Believe me, I really was! I was the clerk who never went home. My first year residents used to order me to go home because I'd still be around at 8 or 9 in the wards even when I wasn't duty.

Our batch was mabait. :) seriously, endorsements used to be a lot more scary before. There was a time in Guazon Hall when the residents used to throw shoes at people endorsing! But that was way before my time, too, thank goodness.

Manggy said...

Oh, please! Kayang-kaya saluhin at itago ang sapatos! Hahaha. I hate bullies-- even intellectual ones.

Got meloinks? said...

hi doc clairebear! thanks for sharing your story. teacher mo pala si megamom. :-)

dr_clairebear said...

megamom is also my sorority sister. :) it's so funny because we got back in touch lang only through blogging!

notsovictor said...

hi. i'm kinda happy i randomly visited your blog this morning. i'm planning to be a doctor too but it's still so far away (i'm just an incoming freshie at UPD) and my uncles (all doctors) are already hounding me regarding what specialty i want to take :)) i never considered internal medicine, but i see the appeal :)

haha. *overshare*

dr_clairebear said...

@victor: okay lang yan! :) you have a long way to go pa, pero if you really want it, kakayanin mo yan.

IM is a lot of fun if you like problem solving and logic, masaya ang mental exercise! pero keep an open mind, magbabago pa yan as you get to the clinics!

Good luck!

(btw, i also love Jack Johnson!)

Joey said...

You're so lucky! One of the things that turned me off IM was a lot of the residents when I was still a lowly clerk were power trippers, to put it kindly (but then I'm from another school naman). I would have blogged about them too being more of tormentors, kaya lang I remember the few nice ones...madadamay sila. The application for internship match was immediately after my IM rotation, and because of my bad experience, I applied in other hospitals for my internship instead.

Thank you so much for visiting my blog. I'm looking forward to your contribution to TBR10. I know you have a lot to say about the matter :).