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DAY IN THE LIFE OF A DOCTOR: Internal Medicine

December 16, 2019


Morning guys. I’m Siobhan, a first year medical resident. Today is Thursday morning and I’m on a new rotation. So I’m on the CTU rotation and you guys are probably wondering ”What is that? I’ve never heard of that.” So that’s the clinical teaching unit and that’s one of our core medicine. And we as internal medicine residents do this four times in the year, this year four blocks. But we also get off service family medicine residents, we get orthopedics, we get some surgeons that come in. So a lot of first year residents come to internal medicine, because you get a lot of great teaching and this is sort of the the bread and butter of medicine. You see everything, we admit everything and it’s sort of like House M.D. So I’ll tell you more about it as we go. So to be honest, I think I’ve been getting a little bit spoiled taking Uber a whole bunch. So I’m going to try to get back into the habit of taking the bus and we will see how long that lasts when I start getting tired with all the call. But for now, it’s time to catch the bus. Just arrived, you’re gonna see that we get a ton of teaching during the day. So today it actually starts out with something called ”grand rounds”. So it’s basically a lecture that all the staff, all the residents go to. Just leaving grand rounds briefly in the middle, hopefully the staff didn’t notice. But I’ve got to go and get the pager from the on-call resident who is about to leave and just get a little bit of handover. So yeah, quickly run down and do that. All right, locked and loaded. So time to head back to grand rounds. All right, so we’re starting the day and we’re just gonna be doing what we call a short running the list. So seeing what patients we’ve got to see today and divide it up. So we’ve got our staff physician here and Amanda, who’s a family physician, family resident, going to be a family doctor and does some training here too. Okay, so it’s really not normal to have a team this small. Normally we have a bunch of medical students and other residents, but today the medical students are writing a final exam and the other resident has a teaching session as well. So they’ll be joining us this afternoon though. All right, so now that we’ve divided up the team, I’ve actually got six patients to see out of 21 on this list, which is actually a very small team. I’ve been on teams with like 35 – 40 patients, especially over the holidays, so this is very manageable. I feel like we’re able to get a little bit more teaching hopefully today, so we’ll see how that goes. So getting down to work. I typically review a patient’s blood work and imaging first, then I go to see the patient and chat with their nurse to see if there have been any new issues. Then I write a note summarizing everything. At this hospital, we’re still writing notes by hand. So if an allied health professional like a dietitian or a pharmacist has a suggestion, they’ll flag it on the chart. And then if I’m ordering a medication or bloodwork, I flag it so it gets processed. I’ll have to see some more patients after my water break. Then the medical team has a big meeting with all the allied health professionals to discuss each patient’s needs. That can include social work, pharmacy, dietician, occupational therapy, physical therapy and speech and language pathology. Just heading down to the oncology ward to see a patient in the cancer center. So it’s just about noon. I’m always running slightly late in the morning, because you try to get a little bit more done than you can. So we’ve got teaching in like two minutes, so I’m gonna hurry and get there. So each day at noon while we’re eating lunch a specialist comes to teach us. Today an infectious disease doctor is coming to teach us about meningitis. Full team is back this afternoon. So we’ve got our two medical students, three residents, so we are totally set. And now because of that, we have less to do and plan to go and get an ultrasound to take a look and see if there’s some fluid in a patient’s belly. So let’s go do that. So it’s 2:30 now and we are meeting with the team, we are doing what we call ”running the list” So basically going through the patients we saw and what we want to do and kind of talk about as a team, get it sort of approved by our staff physician, who’s at the end responsible for all of the decisions that we make. So it’s important that they’re aware of what’s going on. So when we’re running the list and talking about each patient, dr. Chakrabarti always takes the time to teach us important clinical pearls. One of the main presentations if a patient complains of numbness or pain on one side of the face. So then we go for bedside teaching. That means that we see patients as a team and we get their permission to discuss their presentation as a learning experience. I actually find that patients are really happy to be a part of this. So, dr. Chakrabarti will watch us do part of the physical exam, which is incredibly valuable for our learning experience. You know, it actually reminds me of being in music school, where you’re always performing and getting feedback right away. So it’s 5 p.m. now and the day is done, we just handed over to the night team. You can tell, the clinical teaching unit is so much teaching. We get to learn so much and even at night, you know, you learn a ton. I think that my favorite part about the whole experience is that you get to work with teams So I didn’t get a chance to show you the teams in terms of the allied health as much, but I’ll try to do that more in the future, because they’re a huge part and we work with them so much during the day. But otherwise you just basically get to hang out with your friends, see them at lunch, see them even if it’s just during teaching, like it’s a nice experience. It feels like you’re in it together. Probably the toughest thing I think is the amount of call that we do and that just starts to wear you down. It’s so frequent. So I think that’s the most challenging part, because if it was just this type of 8 to 5, it would be great, because you get to know the patients, you follow them day-to-day, you get to see them getting better and if they’re not you start to change your plan. So it’s a really fantastic experience. I think it’s really rewarding, the call can just be a bit draining, especially if you’re doing it for two months straight. So now I’m heading to teach clinical skills to first year medical students, but then when I get home I will try to answer a couple of your questions from Instagram. So, when did I know I wanted to be a doctor? So I think I was 21 actually, and that’s when I kind of really honed in on it. I think I had like ideas in the back of my mind. It was more of my subconscious, but it was 21 that I actually started seriously thinking about it. And before that you guys know, I mean I was doing my music undergrad. I was so focused on performance. It was just different and I’ve been getting so many questions about whether it’s possible for international medical grads, so people who’ve trained in different country for medicine, to come and do their residency in Canada and the answer is yes. We have spots. Absolutely. I haven’t gone through it of course, so I can’t give you advice about that. All I know is that I hear it’s quite competitive and for instance in my year we have two spots open for IMG’s, so international medical grads. And we happen to have a program set up with the Gulf states. So we have students who come over from there, but so yeah… competitive, but definitely possible. So thank you so much for watching guys. It’s always awesome to share a day with you. Don’t forget to subscribe if you haven’t already or turn on your notifications by clicking that little bell. And that helps me out and then you can see the newest videos that are coming out as well. Anyway, leave a comment below if you have any questions. And otherwise, I’ll be chatting with you guys next week. So bye for now!

9 Comments

  • Reply give to live December 17, 2018 at 7:30 am

    Boy this is sure is better than the channel called Bizarre ER

  • Reply badri venkata December 29, 2018 at 10:00 am

    siobhan can u pls tell me from where ur doing ur residency

  • Reply catboinomo January 2, 2019 at 5:48 pm

    Just wondering why you don’t drive? Just curious ??

  • Reply حموده February 12, 2019 at 9:37 pm

    I'm an mbbs second year , i don't like writing notes , i learn by re reading multiple time . Is this method bad for internal medicine?

  • Reply Yashasvini Shivamurthy April 25, 2019 at 7:20 pm

    What is difference between internal medicine family med n all

  • Reply Danielle Griffiths July 9, 2019 at 5:57 pm

    Do u get tired during work and I hope u like my comment xx

  • Reply Basim Trki September 4, 2019 at 9:57 pm

    hi

  • Reply grandmahugzarebestforhearts Idrizow October 7, 2019 at 6:42 pm

    Do your family members ever ask the same questions that we ask when we leave replies in the comment section. Love your videos. Could you please do a video on epilepsy? I have had it for many years and I would really appreciate it if you could explain a little more about what it is like when you are dealing with someone having a siezure when you are on call. Again, absolutely love your videos and absolutely love you. Have an awesome DAY

  • Reply Anthony LaMarche October 21, 2019 at 10:05 pm

    It's kinda inhumane the way residents are worked… Great video, nonetheless.

  • Reply Fisk Thense November 6, 2019 at 12:06 am

    Will you go into a fellowship after residency? If so, which? I really want to do rheumatology!

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