Note: What a typical day looks like is more or less similar for most specialties in Internal Medicine, so for a nice overview you can read my post on A Day in the Life in Internal Medicine.
Monday
This was the very first day of our very first posting, so we had a scheduled orientation session (essentially just a briefing), plus a tour of the hospital. This meant that we weren’t able to join our assigned team for morning rounds. Instead, after lunch, we headed over to say hi and confirm the reporting time for the next day.
Somehow the Nephro team had a “continuation of morning rounds” at 2pm (because the Consultant had clinic in the morning or something). One of my teammates and I stayed back to join their rounds. It was quite interesting in the sense that we began to see the conditions we had been reading about in real patients.
Nothing much exciting happened until we reached a patient who apparently has a tricuspid regurgitation murmur. My friend and I both tried auscultating. We came out saying we couldn’t hear anything, which was met with incredulous “it’s very loud” remarks from the Consultant and HO. (Of course we went back in immediately and tried again. We weren’t 100 percent convinced if there was a wooshing sound or not, but we both picked up a split S2 the second time.)
After leaving the hospital, I immediately began reading up more into some of the things we’d encountered along the way. It was quite exciting and I felt invigorated (was really glad that the first day was not just orientation).
Tuesday
I reached the hospital super early, and was in the ward at 7am. I honestly have no idea why I went so early (I stay really far from the hospital, so had to wake up and leave the house super early as well). I guess I was hoping to see if we could pre-clerk patients before ward rounds. But turns out there were no new admissions for us to clerk (I think there were a few but too sick to talk). So I ended up following a HO on her pre-rounding. I was completely useless, literally just a space-occupying lesion.
The space-occupying lesion life continues at an even grander scale when my teammates arrive and all four of us tag along with the Nephro team for morning rounds. Just imagine eight to ten people crowding around a patient’s bed…
These were some of our first ward rounds so we all followed quite attentively and tried to really pick up on whatever the doctors were saying and doing. The doctors were too busy with the patient load, so if we had questions we whispered among ourselves or tried googling for answers.
In the afternoon we had some hospital IT training session (nothing exciting at all). Also these two days I had some personal mini-crisis so after leaving the hospital I had to go resolve that.
Wednesday
I went early again at around 7am (no idea what I was thinking). Good news was that there were two patients we could clerk. While waiting for my teammates, I tried to do a few flashcards but my sleep-deprived brain refused to focus. (You may have noticed that there really seems to be no time for studying?? You’re absolutely right.)
So we clerked our first patients today. And then we tried presenting during ward rounds to the Consultant. (Only two people could present so I let my teammate do it.)
We’d barely finished lunch when some of us rushed off to see a respiratory case. We listened to the lung sounds, but my untrained ears could hardly tell if the sounds coming through my stethoscope were crepitations or not.
Later in the afternoon, we had a bedside tutorial with one of our Core Tutors. I won’t go into the details, but one thing that happened was that we examined and heard an aortic stenosis murmur, which we all mistook for mitral regurgitation.
Thursday
I think this was when I stopped going at 7am (but still arrived before 7.30am). Level of sleep deprivation has hit new highs.
To start off the day, we went to check in on the same patients we clerked the day before. This time I had the chance to present during ward rounds.
In the early afternoon we did a bedside tutorial with our other Core Tutor. This one was really memorable as well because we saw an interesting neurological condition with clinically apparent signs.
Since we ended somewhat earlier than usual, our team found a nice study spot nearby and settled down for a massive nerd session. Except that once I sat down, I began dozing off immediately. My brain and body just shut down.
So I really didn’t get much done at all before I had to rush off to school to meet my House Tutor (missed the meeting on Wednesday due to tutorials). We had a nice chat about how I’m coping with Year 3. (I stay very far from the hospital and school. I am sleep-deprived. Despite sleeping fewer hours, I have zero hours to study. Oh yes I absolutely look forward to every single day, I still enjoy the learning and the experience. Oh but I am sleep-deprived.)
Friday
Ward rounds has become the usual routine. Most commonly in Nephro you’ll see chronic kidney disease, with most patients in the wards on dialysis.
After lunch, we were supposed to just chill at the Student Lounge before our Teaching Clinic. I can’t recall what we did but we couldn’t sit idle and probably busied ourselves with something going on in the wards.
In the late afternoon we had a Teaching Clinic. We saw one patient with an endocrine condition and another with a renal transplant. As has become the custom this week, we ended at around 5.30pm to 6pm. So concludes an eventful first week of postings.
For patients’ confidentiality, all details and identifiers are omitted. I’m unable to tell each patient’s story (though they’ll definitely be rich and meaningful). For more on my personal experience and struggles as a medical student, you can read about my Med School Life.