Wednesday, March 5, 2014

Update on My Future - Shadowing and Specialties

Source: A Cartoon Guide to Becoming a Doctor: Choosing a Medical Specialty
I still haven't decided on a specialty. I did some more shadowing today in the Emergency Department, this time with a third year resident who is getting ready to finish things up in June. It was a great time shadowing. While I still feel like I know almost nothing in comparison to actual doctors, it no longer feels like I know nothing, as it did just one year ago.

I now recognize drug names (sometimes) and conditions (most times). While I might not be able to rattle off the six most common causes of acute headache that could possibly be urgent in nature, I know what they're talking about when they mention temporal arteritis and why you look for an elevated sed rate. I also understand when the doctor explains that an elevated sed rate is very sensitive for temporal arteritis, but not very specific.

While I don't immediately know the best possible breathing-assistance apparatus to use to help someone with obesity hypoventilation syndrome, I can now look at a blood gas panel and identify that the patient is experiencing acute respiratory acidosis and whether or not it has been partially compensated by renal bicarbonate retention. I know what to listen for when the doctor finds something in the patient's lungs and asks me to note my findings.

One of the coolest things about today's shadowing is that, since I've started the Cardio domain, I can do some limited interpretation of EKG results. While to many docs it's simply old-hat, to me it's still new, and kind of fun to be able to look at a tracing readout and know something about the patient that nobody had to tell you. I can quickly determine heart rate and readily note abnormalities. For example, today a patient's EKG had an abnormally inverted T wave. This can mean a variety of things, but given the patient's clinical presentation, I had an idea of what it might mean.

The 'transformation' is my blog's namesake is happening. I can feel it. I am noticing things during patient examinations and understanding the differential diagnosis discussions far better than I would have thought possible after less than two years in med school. I have a long, LONG way to go yet, but I can see myself doing this job more and more clearly these days. Like I said earlier, I'm still not 100% set on Emergency Medicine, as some aspects of other specialties (specifically Internal Medicine (after all, Hospitalists and Emergency Medicine physicians share a lot) and Surgery (who doesn't like procedures??)) are really attractive to me. However, I'm slowly coming to realize that I could be very happy in a wide variety of specialties, and that's encouraging. The world doesn't hang on one specific specialty for me, and that is relaxing in a way.

Today wasn't the most productive in a Step-1-studying kind of way, but it was really good for me in a future-outlook-and-stress kind of way. Tomorrow will be more geared toward UWorld Questions and board studying, but for today, it was fun to just think about the future. Also, tomorrow I start the West Michigan Therapy Dog program with the first of eight classes. Hobbes won't be joining me for this or the next one, but dogs come to class starting the third week, so that'll be fun.

All right, time to be done with this post. Thanks for reading, and feel free to comment below or use the Contact Me portion of my blog to send your thoughts, complaints, or words of encouragement. Have a great day!

1 comment:

Susan said...

Very interesting post and fun to hear YOU recognize the growth you're experiencing. What encouragement that must be! I can easily see it but that's because I don't get to see it every day as it's happening. Glad it was a great experience today!

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