Hey guys. I'm Siobhan, a first year medical resident. I just finished my outpatient internal medicine rotation, so today
I'm going to share that experience with you. So I'm really excited to tell you guys that I've just got a dedicated
Instagram account for Violin MD. Now I can stay in touch with you guys between my weekly YouTube videos, so find me at violin.md
And you can see more of what my day-to-day life is like and what it's like to be a medical resident
by following my daily story or my posts.
So for the last month
I've been working in what's called a rapid assessment internal medicine clinic. So basically, patients will show up to the emergency department or
they're with their family doctors and they're really not doing so well,
but they're not sick enough to be admitted into hospital.
So they need to see a specialist and they need to see one quickly, so they don't end up in hospital.
So that's why they come and see us. And the idea is, we'll see them once maybe twice.
And then we try to figure out what's wrong, connect them, make a plan and then send them out to doctors
that can take care of them long-term. So this particular clinic has been incredible.
It's actually like a one-stop shop for healthcare. So we've got nursing, pharmacy,
social worker,
occupational therapy. We even actually have a dermatologist who works just down the hall.
He's not part of the clinic, but if I had a rash
and I have no idea what I'm looking at, he'll kind of just pop his head in and give a recommendation.
So the patient doesn't have to book a new appointment. And dermatology appointments take forever to get, so that's really really nice.
So a typical day for me.
Patients are booked first around 8:30,
so I usually wake up around 6:30 or 6:45,
so that I can get a little bit of studying done at home,
have a nice leisurely breakfast. And then I would show up to clinic around 20 minutes early,
so I could look through their chart and
kind of be familiar with the patient. So some common things that we see in clinic all the time are
like a patient who has fainted and we are there to figure out if it's something serious about their heart.
Or we might get a patient who's
unintentionally losing a whole bunch of weight, so the big thing in our minds is ''Is this cancer?'' and we can help with that.
So after I'm done seeing the patient, I go and I find my supervising staff.
It's usually in this big common room and there are often other residents sitting around in there.
And then we review the cases together and talk about them, make sure I'm not missing anything.
And often these supervisors make it into a learning experience, so they teach you something different,
make you think about a problem in a different way. I say the craziest experience was actually seeing patients coming into the
outpatient environment who were really sick, like sick enough that you're thinking
''Why didn't you go to the emergency department?'' So for one patient, our
pharmacist went to see her first, and she was really worried about her.
She came up to me and said ''You know, can you come assess this woman right away?
It doesn't seem right to me.'' So I went in, started chatting with her. She was definitely confused. I
took her vitals and looked at her oxygen saturation. She was in the 70s, which is really not good,
you should be up in the 90s. So you know... I was immediately concerned about her and
I just thought ''Thank goodness, I had just come off the
gastroenterology service'', because all the little hints started coming together.
She started talking about how she's been feeling confused and how our abdomen seems like it's been getting a little bit bigger.
And I don't know if you saw the video about my gastroenterology
rotation, but sometimes these patient with liver problems get these big distended abdomen
with more fluid collecting in it. And I had a feeling maybe that's what was happening to her, so I went and got my
supervising staff, she agreed with me.
And then it was up to me to actually call 911 to make this happen. It actually felt so exciting to call 911.
Something you see in movies and TV shows in these
emergency situations, and finally it was me doing it.
And then to relay the information
as a doctor and to be able to get that patient transferred to the hospital and get the care they need.
So the outpatient experience has been great.
I certainly had more time to myself than I did when I was on the GI or the
gastroenterology service. We often finished up by 4:00 p.m.
So it was the perfect time, spent a bit more time on studying and to be able to catch up with my violin.
This month I collaborated with some amazing musicians and we put on a sold-out concert.
Oh man, it felt so good to be back on stage,
I can't even tell you. It was definitely a challenge to find time to rehearse,
but it was so so worth it. So the best part as I had been having a great lifestyle.
I felt like there were a lot of patients that were coming in, that hadn't been seen by a ton of doctors.
And so there was some really really cool moments where I was able to actually find something new in a
physical exam that helped us figure out what was going on with his patient. So one example...
I was listening to this patient's heartbeat
and I heard a murmur. So rather than hearing normal heartbeat, bum bum bum bum, I heard
woosh woosh woosh.
That told me that the flow coming out of the heart
wasn't quite right, there was probably something wrong with one of his valves. It turned out that was actually a huge part in figuring out
this particular patient. So that was really exciting and it was one of those moments where I really felt like a real doctor.
It was just exciting. Honestly, outpatient internal medicine was such a good experience. It's made me want to incorporate some
inpatient and some outpatient in my practice in the future.
You just get to see a diverse population.
People who can be very sick, not as sick, young, old, it's a really cool mix. So next I'm starting my
inpatient internal medicine experience. So that's on the wards, lots of call, very sick patients, so it's gonna be an adventure.
It's gonna be exhausting and I'll let you guys know about it. So thanks for watching.
Don't forget to subscribe if you haven't already to check out all my different adventures as a new medical resident. Find me on
Instagram at violin.md and comment below to say hi, or let me know what you're thinking. So I'll chat with you guys later