On the first day of ambulatory GIM selective, I was nervous, relieved, and excited.
Having just survived my CaRMS tour and not been around the GIM environment since clerkship, I definitely felt some pressure. I remember being constantly in awe of the Internists' vast knowledge and feeling "inadequate" in comparison. This feeling had accompanied me for nearly all of my core rotation. A year later, I wondered if my experience this time would be different. One thing I did not find nostalgic on my first day was the lengthy orientation and online training modules. It took roughly 3 hours and a trip back and forth between TWH and TGH to get everything settled.
The last task on our agenda today was to attend rounds at lunch. We walked in a bit late and only caught a glimpse of the topic: bacteremia in the context of compromised skin barrier/erythroderma. While trying to chew my food as quietly as possible, I quickly glanced at the differentials outlined on the board and found myself able to come up with most of the diagnoses discussed by the group. Furthermore, I was able to answer a majority of the questions thrown out by the attending staff. Hearing the residents contribute helped round out some of the clear gaps in my knowledge. I thoroughly enjoyed today's teaching rounds. Overall, I found the topic to be extremely relevant to my current stage of training and the knowledge to be very practical. The familiarity of the learning environment gave me some peace of mind, and I remembered why I loved IM in the first place. The multitude of complex medical concerns could be challenging, but there's always support from a team of clerks, residents, and staff. The rare and unique pathology within GIM offers constant clinical challenges but endless learning opportunities also.
I'm excited about what this rotation has to offer. I'm certain my adventures during the next 4 weeks will help shape my future career in medicine.
- AX
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