Woo-hooo! I am currently on my week off after taking Internal Medicine, and it is a well-deserved break! After many nights of sleep deprivation and having countless patients to take care of, I can honestly still say that this was a great rotation. The reason for sleep derivation was because of writing countless “SOAPs”, which is an acronym that means “Subjective, Objective, Assessment, and Plan”. Students will begin learning this during their surgery course in junior year, but it is basically a way of organizing the medical record of a patient. For the “Subjective” portion, you write up the history of the patient (just for Day 1 SOAPs) followed by physical examination findings that are of your personal observations (ex: alertness, lethargic, dehydration status, mucous membrane color, respiratory quality, etc). For the “Objective” portion, these are more accurate, numerical value findings (ex: temperature, heart rate, respiratory breaths per minute, etc) and results from diagnostic tests. The “Assessment” is the most vital portion of the entire SOAP write-up. This is the time where you delve into the top five clinical problems that a patient is currently suffering with. You research and try to determine what could have caused these problems to manifest in this particular patient by looking through various differential diagnoses for each problem. For example, a patient may be suffering with vomiting. A list of differential diagnoses that may be why the patient is vomiting are a foreign body lodged in the gi tract, an obstructed tumor, inflammation of the gi tract itself, toxins, pancreatitis, and so on. Based on the history, clinical signs, and diagnostic tests, this list will continue to decrease until we find the answer for the cause of the patient’s vomiting. The last portion, “Plan”, is self-explanatory. We are listing out the next steps to try and treat for a patient’s particular problem that needs to be rectified. I personally like the concept of writing SOAPs. It helps me see on paper if we have made any improvements for the health of an inpatient, or if we are just wasting valuable time. I also love it because I am learning a lot through my independent time of researching. The only downside of writing SOAPs is that it is incredibly time-consuming doing the assessments for 5 problems! It is particularly hard when your day at the hospital is very busy and you don’t have time to begin writing your SOAPs until you reach home around 6 or 7p some days.
It is important to prepare yourself and to not beat yourself up with cases that may never be solved. Whenever you do get a diagnosis, it is one of the best, rewarding feelings you will experience, but these diagnoses don’t happen as often as in other rotations.
I loved working one-on-one with the faculty veterinarians and residents. Here is where I felt like a veterinarian collaborating with another veterinarian. With the doctors I personally worked with, it felt like my feedback mattered, and I was told what will happen next with the patient during the day. The feeling of teamwork was beautiful in this rotation, with the doctors and especially with your classmates. Help each other out any way you can, and your experience during this rotation will be so much better.
Here’s what other people had to say about it!
(What was Orientation Day like?)
-wrote on a flashcard top 3 goals to accomplish during the rotation/ hopped right into cases (about 10 and there are 8 of us)
(Average Daily hours on duty?)
-if I had inpatients (6a-7p)/ if no inpatients (7:30a-5:30p or until all my patients are discharged)/ If you were signed up for transfer pick ups, you need to reach by the emergency rounds room at 7:30am
(What is the attire? When do you change into scrubs?)
-Business Attire Tues/Thurs and scrubs Mon/Wed/Fri
(What do doctors/residents/techs constantly harp on?)
(What are some struggles to watch out for?)
(Words of encouragement)
I strongly encourage helping each other out throughout this rotation. If someone has more than one inpatient, help them out in the morning with treatments.
(Difficulty Level (1-3)? 1= It’s a breeze/ 3= really difficult workload)
3 out of 3