INTERNAL MEDICINE

INTERNAL MEDICINE

“The glory of medicine is that it is constantly moving forward, that there is always more to learn. The ills of today do not cloud the horizon tomorrow, but act as a spur to a great effort.”

- William James Mayo

       Internal medicine was my very first rotation as a clinical clerk. At first, I really don’t know what to do because we came in from a 3 months vacations and now we were in the hospital.  My first area of rotation was 1300/2000/RA. We were three in the group and they choose me to become RA rotator because they were saying that it was the hardest rotation since RA was not good in clerks. I accepted it because I want to experience how to rotate in RA’s patients. It was hard at first because I already forget what was taught in 3^rd year medical school and RA was always angry to us. I was making my admitting papers the best as I can but still it was a crap for him. I always rounds for his patients and visit them always but still, he was shouting whenever we do rounds to his patients. But that doesn’t make me stop. That makes me realize that it is the real world. I need to learn a lot and what I’m doing was not yet enough. And that’s when I start to love internal medicine.
       My second area of rotation was MICU/SICU. I and Dianna was assigned to MICU. I had a mixed emotions while rotating in the MICU. Most of the patients were in vegetative state and only the doctors were in between the life and death of these patients. Some of the patients were being trans-out to wards as they improved their conditions but most of them died after cardiorespiratory arrest. Also, being a clerk in MICU, you were responsible in monitoring all the patients every hour and report to your senior any deviation in their vital signs. We must be able to do progress notes of each patients assigned to us and to do admitting papers of the newly admitted patients. It was tiring since I was not able to sleep so much due to monitoring of each patients but there was more learning in the MICU since most of the critical cases are in here. Also, most of the consultants make sure that we learn on every patients. 
       My third area of rotation was emergency room. It was the most tiring rotation in internal medicine since patient were non-stop in coming in even at 1am to 4am in the morning. Our census were usually 5o-60 patients per day and they were all quality patients. However, in this area, we learned a lot of skills like inserting IFC, NGT, 12L ECG, reading CT scans, ECG and Chest Xrays, and performing BLS and ACLS. Most of the cases we handled were acute gastroenteritis, BPPV, CVD, NSTEMI, STEMI, UTI, and pneumonia.
        Our next area of rotation was 3700/3500 station. This area was the scariest rotation since most of the patients of big time consultants were admitted here. Dr. Gonzales, Dr. Concepcion, Dr. Perez, Dr. Gutierrez and Dr. Feliciano were some of the consultants having their rounds here. We make sure that our papers were good and that we complete all our progress notes, lab flow sheet and drug index. We also make sure that we know all the cases on each rooms so we were ready if we were asked on the cases of the patients.
        My fifth area of rotation was 3600/3400 which was the same as 3700/3500 but the workload were lessened since there were only few patients admitted in 3400. During our duty in this floor, one of us were assigned to be JWAPOD. It means that one of us must know all the critical patients in the entire building and must assigned every admission and referrals to co-clerks on duty. JWAPOD was also in charge of getting all the laboratory results of each patients since we don’t have SI’s yet. They were also in charge of informing the resident on duty about the conditions of each patients. Also, they are responsible in rundown of admitted patients in their span of duty for morning endorsement.
        My last area of rotation in internal medicine was 1400. It was also one of the toxic floors in UMC. Many of the patients who doesn’t want to be admitted in the MICU where admitted here. When we were duty, we usually have 4-5 intubated patients that we need to monitor every hour. Also, one of you will be assigned as JWAPOD in the first building.