The medicine clerkship is pretty much a big core of med school. Unlike the other rotations I have done, this is what I consider the real deal. Over the next two months I’ll learn about being on call, working long hours, being exhausted, getting grilled by tired and jaded residents, and hopefully I’ll have a lot of fun along the way. For all the newbies in the audience, you may be wondering what is the “medicine” clerkship? Isn’t he in med school, isn’t it all a big giant medicine rotation? No! Medicine means Internal medicine, which is basically the long road that anyone must walk down to reach such specialties as Cardiology, nephrology, Infectious disease, etc. Basically it is the backbone for most things in modern day medicine. So naturally, like modern medicine, it is set up to be a tough and intimidating entity.
For my first month I am at University hospital, and the second month at Tulane. Here's the basic set up, just to run through it once. There are four medicine teams in the hospital, each team consists of two interns a resident two to three med students and an attending that oversees the whole team. Every 4th day my team is “On Call”, which in short means that any new patients that get admitted to the medicine service of University hospital are admitted to our team, and we take care of them for the duration of their stay. The next day a different team is on call, and so on. The idea here is that you admit a bunch of patients one day, then you don’t get any new ones for 3 days, during that time you try to get rid of as many as you can before the next call day rolls around otherwise you will keep exponentially acquiring patients. The hours on call day can be brutal. On my first day of medicine at University our team was on call, and we thought we might be able to go home early because it was our first day and all. When I inquired about how call was going to work today, the reply I got was.. “well you guys can only stay till 11pm because we don’t have enough beds for you to stay the night”. I didn’t mention call is 24 hours longs, and the interns and residents who stay are typically up all night taking patients. The med student gets to go home at 11, only to come back in around 5.
My role as a third year is really doing a lot of scut work. Patients need full physical exams everyday, someone needs to dig through the chart and find buried lab values, run down to lab to get something ordered, go buy dinner for the team, and fill out mind numbing paper work.
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