I've got three more electives and Step 2 CS out of the way and it has flown by! I did my NICU elective in February. This was definitely the most intense rotation that I have had to date. I was paired up with a second year resident and worked the same schedule as he did. Everything he did I was to be doing it too, including meetings and lectures. It was an amazing experience because it really threw you into what the daily routine of working as a resident is like. The typical day went something like this:
7am: arrive, get report, examine all of the babies and decide what tests they need that day, start writing patient notes
9am: rounds with the attending doctor - see all of the babies again and discuss the plan and how they are doing
11am: Grand Rounds - a teaching seminar, journal presentation or some sort of other learning activity
12pm: Lunchtime general pediatrics lecture that all residents in the program attend
In the afternoon, it depends what is happening on the floor. You follow up with tests you ordered, update parents, perform any procedures that need to be done (line placements, circumcisions, etc). The NICU resident also carries a pager that goes off whenever there is a high risk delivery. When it goes off, you run and get ready to resuscitate that baby right after delivery. The day usually wrapped up anywhere between 5 and 6 pm. Every 4th day we had to do a 28 hour call shift. We would work our normal day, and then after that was done we were to stay in the hospital all evening and night and address anything that comes up with the babies during that time, take care of any new admissions, go and retrieve transfers from other hospitals, and run to deliveries. You would start at 7am and the shift would end at 11am the following day. It worked out to be between 70 and 90 hours a week.
I learned an incredible amount in such a short period of time. The NICU is really amazing. The babies are so fragile and so critically ill. It is really amazing to see how far they come (or don’t come) over the course of 4 weeks. Cook County was a great place to do it because I got to see and do so much. I got to care for babies that were less than a pound in weight and with diseases that they told me in lecture that I would never see in real life. That is definitely one of the perks in staying in a big city like Chicago, this was definitely a rotation that I will never forget!
After NICU I did another general pediatrics rotation which was at Presence Resurrection in the northwest suburbs of the city. It is a heavily Polish neighborhood so I got to see a different demographic of patients. It had a more manageable schedule (Monday to Friday 9-5) which was great because I had studying to catch up on after the insanity of the NICU. It was mostly outpatient office visits and newborn assessments in the hospital. The attending doctor was a real pleasure to work with and I learned a ton from her! After the rotation ended, I took 2 weeks off to study for Step 2 CS and then took it in the middle of May. I will definitely share my study tips, but those will come after I get my own results so I can make sure I am actually giving some good advise.
The most recent rotation I finished was Emergency medicine at Mercy hospital. It was a good experience overall, even though emergency medicine is not my cup of tea. It is a large 25 bed ER that is always packed full. That hospital is very student friendly. All of the attendings and residents are accustomed to having students with them and do a great job at challenging students while providing education and support. I was encouraged to see as many patients as I possibly could and to go in and examine any patient that I found to have something interesting going on, even if I wasn’t taking care of that patient directly. As long as you ask permission and the patient agreed there was a lot to see and do. I really didn’t have many patients at that hospital have an issue with being seen by a student. If there were code blues or other bad trauma I was encouraged to get involved and participate as much as possible. I have been in other rotations where you are sort of left in the dark when things get crazy, so it was nice to be included in all that was going on in the ER. The schedule was quite busy and we had day, afternoon, and overnight shifts throughout the month I was there. There was only one other student in the rotation which was really nice because it allowed me to get just that much more exposure. I definitely felt much less comfortable in the ER than I have in other rotations, but I also think it is the rotation that has made me grow the most.
Next up is pediatric allergy/immunology and preparing for residency applications! I will keep you all posted, thanks for following!