My 9th and final rotation was Internal Medicine at NYPQ. This was my second rotation at NYPQ as I was already there for my Surgery rotation so I was pretty familiar with the hospital and their computer system. This rotation was 5 weeks long and I had to do 3, 12/13-hr shifts per week with no overnight shifts. Overall, I enjoyed my time there and I was able to interview and assess a lot of patients during my time at NYPQ.
The shifts at NYPQ started at 7 am and ended at 7/8pm and each week we were assigned to a different floor, usually with the same preceptor for that whole week. When we arrived in the morning we would round with our preceptor and the rest of the PA’s in that floor and go over every single patient in our list for that day. IM at NYPQ was a busy place and PA’s there had an average of 15-18 patients per day which led to a very busy day. If there was an interesting case/patient, I would follow them for the rest of the week and write my H&P on them. As I got more comfortable I was able to draw blood and do ABG’s by myself and I was also able to replace NG tubes as well. I was also able to assist in a lumbar puncture and I&D of an abscess.
One element I loved during this rotation was the ability to join the stroke team. I was part of the stroke team for a week and I truly enjoyed my time there. I got to see the role of a PA in the stroke team and how they would assess each patient where stroke was the main concern. It was very interesting to see how quickly they performed their neurological exam and how quick patient was sent for CT to rule in/out acute stroke. I was also lucky to observe a mechanical thrombectomy as patient was out of the time window to start on tPA.
One memorable experience during this rotation was when I replaced my first NG tube. I asked the PA to observe me as I first took it out and then insert a new NG tube. The process was smooth and fortunately nothing went wrong. Another memorable experience was when I assisted with a lumbar puncture. The PA was the one who did the insertion as I was still uncomfortable to do it on my first try.
One challenge I experienced during my IM rotation was trying to read full H&P’s and the full hospital course of 15-18 patients every shift. Every shift almost all our patients were new and it would take me and the PA a good 2-3 to go through each patient and what had been done what needs to be done that day for them. There was a lot of planning and constant update to the charts. However, one way I overcame this was by getting a good sleep the night before and when going over the charts I only focused on the doctors/ PA/ NP notes and also consult notes and If I needed more information I would check the rest of the notes as well. Overall, this was a great rotation and enjoyed it a lot.
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