People were always amazed when I told them I was returning for not one, but two elective weeks on Internal Medicine. Most people chose something fun as an elective, with weekends off or at least shorter days to give themselves a bit of a breather. Internal Medicine was infamous for its long days and slim possibility of even a half-day off, and the caseload was so high that no one in their right mind would describe Internal Medicine as a fun rotation.
But that’s almost precisely why I returned to Internal Medicine: I was so overwhelmed and miserable during my 3 week core rotation that I felt I didn’t get to learn as much as I ought to have. Sure, some of the cases at a referral hospital are very complex— and not something I’d expect to see often in general practice—but they are an excellent review of disease interactions and how to prioritize a patient’s problems.
During my recent elective weeks, I had a number of patients with kidney disease and liver disease, which helped solidify my knowledge of a complete diagnostic workup and most likely differentials. I also had some atypical cases: A Yorkie with a immune-mediated pancytopenia with a concurrent ascending bacterial infection of the liver; a tiny Boston terrier pup with an esophageal motility disorder and sliding hiatal hernia; and a German shepherd with a severe case of pancreatitis that caused acute hepatitis and liver failure, resulting in a life-threatening clotting disorder.
Each elective week was a whirlwind, but I felt more able to weather the storm with more knowledge and stress-management skills under my belt.