Pimping

Rotations started last Monday. Been 1 week. Some thoughts—

• There’s so much…I don't know. I recall the keynote speaker at our clinicians ceremony saying that the firehose of info that’s been fired at us first two years has now been turned to full blast. I recall thinking that’s hard to believe. I confirm now that’s totally true.
• My first rotation is internal medicine. Sure, there’s a ton to be learned from it, but I don’t know if I'm in love with it as much as I thought I’d be. Maybe emergency med or OB/GYN is right for me?
• I'm frustrated that I can’t remember facts much less speak up quickly on rounds…I don't know. I need to review more? I need to stop overthinking? I need more quality rest time?

Final thought of the day: So I got brutally pimped today. I knew my info, but the amount of detail the attending asked of me was the level of a fellow—the senior resident told me so afterwards, and even the attending at the time acknowledged it, but he did it anyway. Now I know hyperthyroidism & Graves’ disease like the back of my hand. However, as prepared as I was, there are things I wish I did differently today—and it’s always the same—be confident in the things you do know. For things you don’t know, don’t be afraid to say, “I don’t know.”

"Clinical Judgment"

So much of clinical judgment is subjective. It doesn't just encompass making difficult decisions based on evidence based medicine and undeniably correctly interpreted results/physical exam findings/history, it also encompasses the actual interpretation of the aforementioned… how much epigastric pain do you believe he’s really having if he’s eating so well? Did he really have a 40 lb weight loss over 1 month if you had to dig that info out from him, and even then you had to ask if his belt & clothing size changed to assess how much weight loss he had? This is why no amount of evidence based medicine and technology will ever replace physicians, and why we have to be so careful about who we give the privilege of becoming physicians to..