Initial Impressions and General Musings (#1)

Tina Zhu

I have now spent three days on this new selective rotation of Ambulatory Internal Medicine and Medical Education.  This was a rotation that I looked forward to with high anticipation, excited to finish off my 4 years of medical training working alongside educators such as Dr. C, Dr. HPK, and the rest of the "think tank".  So far, Dr. HPK's clinic has lived up to its name.  In the span of two clinic days, I have seen patients with Addison's, dermatomyositis, and Behcet's disease, all of which I have only ever heard of during lectures but never witnessed.  No wonder Dr. HPK had been dubbed as "House, but nicer".


Having been away from General Internal Medicine for over 6 months, I felt somewhat overwhelmed on my first day, for many reasons.  Firstly, I was appalled by the amount of information that I had forgotten.  More than a few times, I opened my mouth to supply the correct diagnosis only to find, belatedly, that the neuronal connections that once led me to that particular bit of knowledge has dissipated, or worse, replaced by some stupid Charlie Sheen factoid. I guess that is one of the many reasons why medicine is a life-long learning, for not only are there always new information to be acquired, there are often more old information that needs to be re-visited.

Secondly, I must admit that Dr. HPK's teaching style took some getting use to initially.  I frequently found myself trying to answer a random question only to realize, much to my embarrassment, that the "random" question was meant to be a well-thought out phonetic hint to the correct answer.  Over the past 2 days, I have become much more adept at deciphering the hints and my efficiency in clinic has improved. When I reflected on the cases I saw in clinic in the evenings, I found that I could most easily recall the cases that were associated with the most outrageous hints. Ultimately, I did find it to be an efficient way of learning during ambulatory clinics.

Throughout my medical training, I have worked with various clinicians in clinic and they each had their own styles of teaching.  Some would delve deeply into the details of pathophysiology and disease manifestations for each case while others may highlight the pertinent points and assign the rest for self-study.  Certain educators liked to employ technology such as the Whiteboard or "Harvey" (the simulator) for further teaching and illustration.  Thus far in my training, I have always been the "receiver" of the knowledge transfer and I personally have benefited most from more interactive teaching styles, but as I enter residency, I will soon have to become the "deliverer", a role that I am not at all comfortable with...yet.  Hopefully this selective rotation will help me mature into this role more quickly.