The first couple of weeks of Family Medicine are wrapping up. Overall, I can say that I have had a pretty good experience so far and I have learned a lot in two weeks!
The family medicine program here at Jackson Park Hospital is a little different than a typical family medicine program. Jackson Park has a family medicine residency program, so there are about 20 residents completing their program here at the moment. Since they are the only residents at JPH, they do a lot more than you would think would be typical of a family doc. There is a clinic attached to the hospital, so they work there - in this aspect they do things that you think about when you think about family med - see patients for non urgent complaints, give vaccinations, health check ups, medication refills, health prevention screening, and refer patients to specialists, or to the ER if necessary. There are tons of other reasons people come to the clinic of course.
They also work throughout the hospital. They manage medical, surgical, and ICU patients. They essentially run the show here. Of course, there is an attending physician assigned to each patient who is admitted, and the attendings do rounds with the residents at least once a day to make sure everything is being done as it should.
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| The view from my apartment in Chicago! |
As a student doing family medicine here, we also get to see and do things outside of the clinic as well. There are 1 or 2 students assigned to an attending, so the student doctor ratio is good. Unfortunately, it isn’t the same story for other rotations here - in internal medicine, for example, there are 10 or 12 students in a group with one attending. I am going to focus this post on the family medicine rotation, however.
There were about 10 of us starting our family medicine rotations here in January and we were split up amongst the family medicine attendings. In talking with the other students, it is clear that our experiences are all different - and that is largely dependent on which attending you are assigned to.
What I am assigned to do depends on what my attending is doing that day. Last week he was covering the clinic, so we worked there. We come to the hospital at 730 every morning and attend grand rounds with the residents. It is just a pretty informal meeting where there residents have to take turns doing lectures on various topics. When that is over, we review interesting cases that are in the hospital at the moment. We look at X-rays, CT scans, lab work and have a discussion about what is going on and what the plan should be for them going forward. I definitely learn a lot in these discussions. After rounds, we head to the clinic. The residents see the patients and report to the attending, so we each find a resident to stick with and follow them all day long.
On Monday mornings and Thursday afternoons, my attending sees his own patients so we are with him. He has us go and see the patients first, then report to him, and then we go and see them together.
This week, our attending was on call on the ward. We came in for grand rounds at 730 as usual, then followed along for morning rounds on the ward. This is definitely where I have learned the most so far! As we do rounds, we discuss what is going on, look at the patient’s EKGs, labs, and other imaging studies, and talk about a plan. Our attending drills us a lot during the rounds, asking us all sorts of questions. After rounds are done, we pair up with a resident and help them with admissions or whatever else they can use us for.
During the rotation we have to do on call shifts. We have to come in at 730 as usual and then stay the whole day and the whole night, and then stay for grand rounds and floor rounds the next morning which lasts until around 11am, and then we get the rest of that day off.
There is definitely a lot that could be improved in this rotation too. Each day is kind of hit or miss, and a lot of that really depends on which resident you are paired up with. Some residents are GREAT. They are enthusiastic and are happy to have you with them. They teach you and quiz you and let you help them with procedures. Some let you do procedures if you are comfortable with it and they are there to guide you. Others are much less enthusiastic and will let you follow them but don’t really acknowledge that you are there, or they will direct you to an area to sit and they’ll say “I’ll come and get you if there is anything interesting”, and you mostly likely won’t see them again. I am sure that is pretty standard though and there are always people who are more willing to teach than others, this program just lacks some structure.
My other huge complaint is that the hospital just isn’t really set up for students. They don’t allow students to have access to the computer (most hospitals will assign each student their own login so their activity on the computers can be monitored) which makes it impossible to look up any information on the patients we are looking after. Because of this, we don’t get to do any documentation which is something I know is an important skill to develop. After doing a history and physical on a patient, it is almost like it never happened when it is not documented. On top of this, the unit is absolutely littered with students every day. It is not uncommon to see 40 or more students on the unit in any given morning which I think is a little excessive.
I have managed to book a few more rotations for when this one is finished. I will be doing my 6 week psychiatry rotation next, starting at the end of February as soon as this rotation is over. It will also be at this same hospital. After that, I will be heading to Virginia to do surgery for 12 weeks immediately followed by IM for 12 weeks. I am definitely looking forward to the move - I have several friends doing rotations in Virginia currently and they all having a great experience there.
Thank you all for following and I will post another update soon!
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