Clinical Interlude II

I found that the team was structured to teach the least experienced. When a question came up, the medical student first described what she knew. Then the intern would add or embellish the answer. The attending or resident would only step in if necessary to revise the answer (or to throw in a completely random trivia fact: guttae in Latin means drops, so sometimes prescriptions have the abbreviation gtt).

The pace was fast and busy. On the first day, our team was on call and received an admission during morning rounds. The third year and an intern rushed down to the ED to admit her while the rest of us rounded on the other patients. During rounds, pagers would go off, people would make phone calls, and others would hunt down a computer to show an X-ray. Sometimes, less than half the team was paying attention to the person presenting the patient. Of course, everyone on the team was already familiar with the patient, so I was not alarmed.

The culture of medicine struck me as highly intellectual. While surgeons and anesthesiologists seem to favor procedures, the medicine service enjoys standing around and figuring out odd cases through discussion. Being able to do an effective differential and explain it was very important. The chief residents stood out during the noon conferences because they clearly knew the most. It was important to some members of the team to be able to pull out an article from JAMA or cite relevant clinical research.