Day in the life in the Internal Med department

Work my friends,

is good practice.

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As many of you already know, I’ve spent the past 7 weeks in the internal medicine department in Mikkeli Central Hospital in Mikkeli, Finland. I applied for an intern position last summer in this department and was thrilled to accept the position last fall. An informative, educational, grueling academic year later I felt prepared to work in the department.

My job (‘Amanuenssi’ in Finnish) consisted of working in the department under the supervision of senior physicians.

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The idea of this practice was to gain a strong insight into the practical daily work of a doctor. Each day I had the privilege to follow their work, discuss the patient’s care progression, plans and treatment options.

Internal medicine consists of cardiac, infectious disease, pulmonary, endocrinological, hematological and acute care patients. I have very little experience both theoretically and practically in each of these fields, so this job was certainly challenging!

Let’s just say a lot of consultations were made…

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The challenge was exciting and learning felt fulfilling. Applying the theoretical knowledge I learned over the past few years was rewarding. Finally we put those crammed exam facts to use!

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In the bed ward, the day starts with reading patient charts, seeing what has happened overnight since you left the previous day, and also familiarizing yourself with the new patients (if any.) Often times, the senior physician will ask me something regarding the patient’s progress: “Why do you think this patient’s creatinine has risen?” or, “what do you think made this patient anemic?” I loved these quizzes, because I felt challenged and dug deep to apply what I’ve learned from textbooks into practical use.  Since these morning pop-quizzes came with a lesson answering the question, I learned a lot from these tests!

Once you have an idea how the patient’s condition has progressed and how you’d like to proceed, we started rounds. The senior physician went to each patient in the ward , asked how they were doing  and discussed with the patient the plans they had in mind. Once a care agreement was made, I would often write the orders, upcoming lab tests, radiology exams into the computer we trollied around with us. If I was familiar with a patient, often the senior physician would let me examine the patient, which was naturally followed by “How would you proceed if you were his/her doctor?”

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(The above photo is an echocardiogram , ie, an ultrasound of the heart, my collegue performed on me. She’s specializing and wanted practice. I volunteered 🙂 )

Rounds typically last 2-4 hours, depending on how complicated cases we have , how slow I type, or how many questions I ask.  After rounds are finished, we go back to the doctor’s room to write the most critical radiology exam requests and lab reports. By this time my stomach is screaming like a baby elephant telling me it’s time to go to lunch. Since you usually go to lunch with your collegues, the lunchroom ends up being the most segregated little flashback from the 50s in the States:

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Separate whites from blacks all over again?
Once, I made it a point to put my tray down at a “nurses table” (to clarify: a table where only nurses sit, tables are not otherwise classified) before my other collegues arrived. They proceeded to put their tray down at the “doctors’ table” and called over to me “Katrina! Over here! Come sit with us!”  True story! I’ll continue this tangent even further by saying doctors and nurses have a kind, non-hierarchal relationship in the hospital. This lunchroom separation is understandable partly because you sit with those you go to lunch with, and you typically go to lunch with whoever is around you when lunchtime rolls around. Nurses are usually working with nurses and doctors with doctors, but when we’re in the lunchroom, can’t we mix and mingle there? Lunchroom segregation is becoming a thing.

Anyway. Back to work 🙂 After lunch it’s back to the office. The afternoon flies by typically writing prescriptions, discharge papers, pharmaceutical certificates, other medical statements, taking samples, me asking six million questions, and admitting new patients into the ward.

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And all is fueled by coffee 😉 On a good day, wonderful collegues like Fanni will bring freshly baked goods or other will-power testing temptations.

Next week will be my final week at this job, and I’ll be in the emergency room! As for now, saying goodbye to the bedward feels awfully bittersweet. I’ve had such incredible mentors. I’m truly grateful!

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2 thoughts on “Day in the life in the Internal Med department

  1. Pingback: Thank you for the summer | Katrina Walker

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