Tag: doctor-in-training

First Impressions: Family Medicine

I’m 2 weeks into my rural family medicine rotation, and I am loving it so far.

For those of you unaware, family medicine is something in Canada that is similar but different than a general practitioner in most countries.  Like a GP, they are the doctor that you will see for your check-ups, and at walk-in clinics.  Unlike a GP, they have a large focus on prevention and are considered a ‘specialty’ as they do undergo additional training after obtaining their MD.

To explain it as simply as possible, Family Doctors specialize in illness prevention, harm reduction, and the therapeutic relationship.  They get to know their patients, they form an ongoing doctor-patient relationship with their patients, and they use this relationship to either prevent their patients from getting sick (lifestyle advice, smoking cessation, etc), or to reduce the harm that might result from their patients getting sick (screening for disease early, or treating illness before patients become sick enough for the emergency room).

I love this aspect of family medicine.  I love talking and forming that trust with people.  I love learning about their lives and their context.  I love being able to help them figure out ways to stay healthy or get healthy.

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So what are my problems so far?  Well, #1 would be that I am realizing how much I don’t know.  And that sucks.  Family Medicine is extremely broad in scope.  It has “99 core topics”, ranging from abdominal pain to stroke to depression.  To put it simply, there is a lot to know.  You have to know a little bit of everything to be a good family doctor.  And as this is my first rotation, I basically know a little bit of nothing.  Or so it feels.

So I spend a lot of my time realizing how much I don’t know, looking up my knowledge gaps, then realizing that I still don’t know enough, rinse and repeat.  That is my life right now.  So it sucks but I feel like I’m constantly pushing and learning.

The other thing I’m struggling with is time management.  Of course, I’ve been told that as a student, that is totally normal.  They don’t care how long I take, as long as I get all the information.  I understand this, but still… I wish I wasn’t quite as slow as I was.

And then there’s the situations that I just can’t help with.  The complex social situations that you know is contributing to people’s health struggles, but simply seem to fall outside the scope of a family doctor.  Things like poverty, racism, and cruelty.  I can offer support, but how can I go about changing things like the structural poverty that many face?  It’s extremely frustrating and sad.  Obviously moreso for the person dealing with it, but unfortunately I can’t close my heart to things like that.  It’s tiring and draining and so hard.

So, that is my first impression of Family Medicine.  Definitely something to love, definitely something that I’m interested in doing.  In a few weeks, I’ll post an update, since I have some exciting novel encounters coming up including shifts at the Emergency Room, TransHealth Clinic, and Addiction Clinic.

 

Until next,

TWS

 

 

Terricited

It is the beginning of my next journey. After 2 long years of study and work (and 1 year of a sabbatical of volunteering and work), I am finally at the beginning of clerkship. Never before have I been so excited, nor so terrified. Terricited, if you will.

For those of you reading who may not be familiar with medical school terminology, ‘clerkship’ refers to the last 2 (or around 2) years of medical school in Canada where we assume clinical responsibility. Whereas the first two years is mostly theory with some clinical practice, the last two years is mostly clinical practice with application of that theory that we desperately learnt during the first two years.

For the first two years, the worst thing that can happen is that you fail an exam. The thing about that is that the consequences begin and end with you. If you fail an exam, then you re-write it, and learn that information that you might not have known well enough.

In clerkship, however, the consequences do not end with you. You are responsible for patient care. Although you should be getting overseen by somebody more responsible and knowledgable than yourself, mistakes can happen. Things can slip through the cracks. You can hurt somebody. That is terrifying beyond measure.

However, it is also so much closer to real medicine than the first two years. Finally, you are practicing and experiencing medicine. You can talk to patients, and help them cope, and maybe catch something that might have been missed. You can spend time with patients, and learn their stories, and be there for them. That is exciting beyond belief.

I begin my first rotation tomorrow. This is the beginning of my clerkship journey.

 

Now, before I leave, a disclaimer of what this new section of the blog will be, and more importantly, what it won’t be.

This will be a blog where I share my thoughts, my reflections, and my beliefs. This will NOT, however, be a blog that will contain ANY details of any patients, doctors, classmates, or anything else identifying of anybody I meet. The only exception to this will be if I have the absolute and ethical permission of those involved.

Hope you have fun reading.