I recently embarked on my third year of medical school and I am starting Week 3 of my 10 week-long Internal Medicine (IM) posting today. The first two weeks and last five weeks are spent in the wards, while the middle three weeks are reserved for home-based learning, where we will attend online lectures and tutorials. We have been scheduled to spend each week in the wards attached to different specialties, which increases our exposure to the various disciplines within IM.
Prior to starting third year officially two weeks ago, a few seniors were kind enough to give me some tips and advice on how to tackle my first year as a clinical student. This gave me a much better idea of what to expect in the wards, as well as how to best optimise my learning in a hospital setting. I was looking forward to starting school as I would get the opportunity to work with patients, doctors and allied healthcare professionals, where learning becomes much more interactive.
This is how my typical day looks like:
6am – Reveille
As I usually wake up after 8am during the holidays, it took me a few days to get accustomed to waking up at 6am. It got better over time!
7.30am – Arrival at the ward
Upon reaching the ward, I would ask the junior doctor for a list of patients who were admitted overnight and go on to clerk these patients. I would spend some time taking their history and perform relevant physical examinations. Then, I would access the computer system to take note of any updates for the existing patients.
I spent my first week at the Acute Medical Unit (AMU) and my second week at the cardiology ward. Patients in the AMU are typically transferred from the emergency department. At the AMU, they undergo investigations and treatment before getting discharged or admitted to a specialty ward. I saw patients who presented with shortness of breath, abdominal pain, headaches, falls and difficulty swallowing. At the cardiology ward, I managed to see patients with heart failure, arrhythmias and heart attacks (who received emergency treatment and were recovering in the ward).
9am – Ward rounds begin
During ward rounds, the consultant, resident and other junior doctors would go to each patient under the team’s care and formulate an appropriate management plan for that patient. Sometimes, the consultant would quiz us to impart bits of knowledge that were relevant to a particular patient’s condition. Occasionally, I got the opportunity to present a summary of a new patient’s history to the consultant. Most of the time, the consultant would point out that I had missed out on some crucial bits of information regarding the patient. This was where learning took place, as I would scribble on my iPad mini to take note of my mistakes.
11am – Tutorials/Clinics
After ward rounds, we would attend bedside or didactic tutorials given by the consultant, resident, junior doctor or our allocated core tutors. For bedside tutorials, we got to clerk and examine patients under the supervision of the doctor, who would then teach us and provide feedback. For didactic tutorials, we would have a discussion on a particular condition or topic. In addition, I got to attend an outpatient clinic, where patients with chronic diseases saw the specialist for consultation and follow-up.
1pm – Lunch
Due to COVID-19 restrictions, we were told to purchase food and consume lunch at the student lounge. As there are 6 of us in my clinical group, we are split into 2 trios and each trio is allocated to a different ward. As a result, we hardly saw each other, except during lunch if our lunchtime coincided. At times, we would study together at the student lounge if there was nothing scheduled for that afternoon.
2pm – Tutorials/Lectures/Self-study
After lunch, we might have more tutorials or online lectures. Otherwise, we could utilise the time for self-study and revision. We could also head back to the wards to clerk other patients and read up about their condition on the computer system.
5pm – Head home
6pm – Gym/Revision
I try to use my home gym every other day to keep active and healthy. On my rest days, I would use the time to consolidate my learning for the day and read up on specific topics that I had encountered.
7pm – Dinner
8pm – Revision
10pm – Lights out
I set out to get at least 7.5 hours of sleep each night, as I firmly believe that adequate sleep is extremely important in helping me solidify my learning for the day. I would also be able to wake up energised the next morning and not feel sleepy throughout the day.
I will be back with another post in 2 months to sum up my IM experience at the end of the posting!
Kaiser 