I spent this rotation at New York Presbyterian Queens in the Internal Medicine department. During this rotation I was able to spend 3 weeks on the day shift, 1 week on night shifts and 1 week on stroke. I was able to gain a lot of knowledge during these weeks and experience using Epic, which is a common EMR used in hospitals. During this rotation I was able to gain more experience presenting patients to my preceptors as I was typically given a certain number of patients a day to read up on and follow. I would then go to see them myself and report back, after which we would return to see them together along with rounding on the remainder of patients. I also got to practice writing progress notes, which we would then review and edit. I was allowed to work on patient charts when they were being newly admitted. I also enjoyed having the exposure to stroke. Neurology was a weakness of mine, but I was able to learn a lot and given many great articles to read that helped clarify details and relate them to the real world. On stroke consults I was able to see a variety of patients such as Bell’s palsy, sickle cell disease, etc. Seeing tPA administered was also very interesting and solidified in my brain more the contraindications to tPA, time frame window, etc that are crucial to this patient population.

Compared to previous rotations, I enjoyed seeing a variety of cases. Although I would see a lot of more common diagnoses such as heart failure, pneumonia, UTI, COVID, etc, I was also able to see other cases such as heart blocks, SVT, a fib, etc, which I have seen less often. I also enjoyed being able to go on codes. For example, I was able to see an SVT code, cardiac arrest, respiratory distress, along with other codes. It was interesting to see the rapid response team respond and what their mechanism of collecting a history while also working to stabilize the patient was. The procedures offered at this rotation was a bit limited. However, I was able to perform my first NG tube placement under the supervision of a PA along with a few other procedures that I have previously practiced.

My next rotation is emergency medicine and I think this will be a good transition as they both focus on broad medical care. I am looking forward to the change of pace compared to internal medicine. One goal for this rotation are to gain more practice with procedures such as suturing, which I have not done since my earlier rotations, IVs, etc. Another goal is to learn how to quickly triage patients to understand which cases need more emergent treatment. I would like to further work on developing/refining a differential diagnosis which I think will be accomplished by seeing multiple patients in the ED. I enjoyed being exposed to the inpatient population and it will allow me to better form my plan for patients that I will be seeing in the ED.