Internal medicine was the first clinical rotation of my second year as a Physician Assistant student and was a challenging yet invaluable experience which was crucial for laying an essential foundation for the entire clinical year. It was a great balance of investigation and subsequent application in the clinical setting. To this day, what I remember most and am able to apply in a clinical situation is what I learned while on this rotation. Each day generally began with a morning case presentation by a resident with the expectation that we students, interns and residents would make a contribution to determining the diagnosis. The case presented was considered what one would call a “zebra” in the medical community, which means it was a disease rarely observed in the common inpatient population. You can imagine the challenge and overwhelming feeling this would invoke in a student with little medical experience! Afterwards, I would meet up with the general medicine team I was assigned to, which consisted of two students including myself, an intern and the lead resident. We would round on patients to check on their medical status and see if anything needed to be changed or added to their treatment regimen. Always, there was work to be done in regard to figuring out medical problems associated with patients, preparing individuals for discharge and planning for more admissions from the ED. Days were intense, with taxing long hours. It sometimes felt like I could barely catch my breath before it all started again the next day bright and early.
With all this being said, I looked forward to each day on the general medicine service and embraced the challenge and demand of this rotation. I knew this was a wonderful opportunity to learn and I tried very hard to be a “sponge” and absorb all the information I could (like our PA faculty had advised us to, as a means to be successful in our clinical year). I very much enjoyed being part of a team, working closely with others, sharing ideas, and getting to know them on a more personal level. To top it off, I was assigned to a team led by an awesome third year resident, who wanted to share his knowledge and really seemed to have an understanding of what it meant to be a leader. He was patient, encouraging and never once spoke condescendingly to me. I remember fondly the round-table discussions involving our team and the attending where we discussed in detail each patient’s condition, as all possible approaches to diagnosis and treatment were exhausted. I picked up on so many bits of information during that time and really developed an appreciation for the thoroughness dedicated to each patient. In the end, one of the most important points I took away from this rotation is the greater the investment the greater the knowledge gained. I will always remember this time and it still serves as a reminder for subsequent rotations that rewards are reaped when my energy is fully devoted to the experience.