Internal Medicine: The "Classic" Physician

By Brent Schnipke

If the average reader is asked to imagine a typical medical student, he or she might picture the following scene: a group of frazzled young people in short white coats, scurrying around the wards of a large academic medical center. They travel in hordes, flocking to the nearest attending, who calmly asks them asinine questions and then chides them for their lack of knowledge. This scene is stereotypical of an often-stereotyped field, and might be something one would see in a caricature of the hospital – on a show such as Grey’s Anatomy or Scrubs. Although this is only one example of what medical education can look like, it is helpful for giving a simplified look at the life of a third-year medical student in the throes of clinical rotations.

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All in the Family: A Profile of Family Medicine

Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third-year student.
My first day on Family Medicine might be the best depiction of the specialty: my clinical preceptor and I moved between our three clinic rooms, barely able to keep up with the 20+ patients that had appointments. We saw a patient following up on depression with new-onset low back pain; a middle-aged woman with a classic urinary tract infection; a husband and wife geriatric wellness visit; an adult woman with diabetes; a 9-year-old with strep throat; and a few cases of sinus infection to round out the day. By the end, I was exhausted and wondered how I would ever learn everything that my preceptor knew about such a wide variety of disease processes and patients. By the end of the rotation, I was still nowhere near his level or my other professors’ – years of residency and clinical experience still separate us – but had at least developed a sense of how to manage many of the common illnesses, and feel that I have a good understand of the breadth and variety of family medicine.

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