Finally Got That MD, Now what?

I started residency a couple months ago, and it’s been crazy! It’s still strange to think that after over 20 years of school, this is my first real job. It’s definitely not like the movies. On the first day of residency, you basically revert to a first year med student. No idea how the EMR system works, and definitely no idea how to prescribe anything since we never learned doses in school! My first month of residency was on the family medicine wards. Most programs don’t do this, but since the majority of FM intern year is spent off service, it’s a nice way to get to know my co-interns before we all disperse throughout the hospital. Our first month, all 10 of us are on FM wards with 2 upper years. This gives us time to learn the EMR and understand what is expected of us day to day. You will learn to have PTSD from that pager sound.  In Family Medicine wards, we see our own patients in the ED,  admit them if needed and also see patients on the floors. If any of the patients need procedures, then they’re yours to perform. If there’s a lot of patients, this can get very tiring running around from floor to floor. Of course, there were 10 of us dividing all this work, so it was much easier than a real FM ward month where there’s probably only 3 residents. After a slow start in FM wards, I moved onto OB. OB was the complete opposite of FM Wards.

Tip: if you’re even considering doing any OB from FM make sure you ask the program or residents directly during interviews.

I personally, never had much interest in OB. My ideal OB rotation would be doing some pap smears, pelvic exams and perhaps some low-risk vaginal deliveries. Our OB rotation at LSU is more of an observer rotation. Especially in the beginning months, the OB interns are also new and have to be trained so there’s very little room for the “off-service” interns to learn. I spent most of my days installing nexplanons and most of my nights studying. Overall, not my favorite rotation, but as I said, OB was never a huge interest of mine. My next rotation for the month of September was NICU/nursery. This month went by pretty fast. Since NICU is pretty intense level care, there was no expectation for me to actually be able to manage a truly ill newborn. Most of my time was spent putting in orders that the nurses told me or calling the NP for help. Overall, a good rotation to learn about congenital abnormalities, but definitely not really in the scope of Family Practice. After 2 weeks of NICU, I moved onto Nursery. This was the first rotation I felt was truly useful. Newborn nursery houses pretty much all healthy infants. This was a great rotation for learning how to do a newborn exam and understanding the risks and benefits of breastfeeding. There’s a high turn-over rate in Nursery so there’s constantly notes to write and babies to exam. I thought this would’ve been a great rotation to do for the whole month!

I am now doing my Pediatric Clinic rotation. Clinic is always fun and frustrating. Patients are not assigned to a doctor, but instead all the charts are placed on a stand and each residents grabs the next chart available.  It’s constantly busy with some residents seeing anywhere from 12-18 patients a day. Most of the kids in peds clinic are healthy and just require check-ups. There’s the occasional weird rash and many birth defects, but you just hope you don’t pick up those charts. So far my experience in peds has been very positive. In peds clinic you learn how to write notes fast and manage common pediatric conditions such as eczema, allergies, jaundice etc. As a family medicine resident on pediatrics, I can definitely see the benefit of being able to see some children in the future since some families have so many kids and it would be easier if they could all see 1 doctor.

Overall, my first couple months in residency at LSU has been very positive. Since LSU is a safety net hospital, one of the benefits is having strong case management and social work departments as well as having the ability to learn and do everything yourself.  I did all my rotations in NY and I find that some of the differences between working in NY and Louisiana is that in NY everything is at your disposal. Every consult you can imagine will be called on every patient. At LSU, the resources are limited so we never consult unless absolutely needed. I find this beneficial so that later on I will have all the skills to practice truly as a generalist. Lastly, I feel that my experience at SGU has opened me up to a wider range of medical knowledge. Coming from a Caribbean school, I was always told that there were barriers to matching and that scores are all that matter. Throughout my interview season, I constantly met SGU alumni that were so excited to see other SGU interviewees. SGU was a great opportunity to pursue medicine at an amazing school.

 

Here’s another great article by an SGU almuni!

https://www.medschooltutors.com/blog/on-being-a-caribbean-medical-student-an-evolution-from-embarrassment-to-pride

 

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