I was nervous about my first rotation being internal medicine as I knew it encompassed everything, I learned in clinical medicine, and even though it was challenging I learned a lot. Internal medicine allowed me to rotate across various floors of general medicine which allowed me to gain experience working-up new emergency department admits along with the day-to-day care and eventual discharge. The rotation also allowed me to see how end-of-care discussions take place with the patient and family members. The rotation also gave a feel of day-to-day operations, and how internal medicine takes a holistic approach to medicine. On this rotation, I saw a lot of consults with surgery specialties, and medical specialties and how specialties work to address a patient that has multiple issues and will require multiple specialties to get involved, and how valuable PA’s are when it comes to treating patients.

The PA’s I worked with were great at explaining things and allowed me to perform several procedures such as venipuncture, IV line, and ABGs. I was excited to perform procedures but I had some difficulty with IV, and Venipunctures because a lot of the patients were old, and we had to use their hands to get access, which is something I’ve never done.  After several times I got a good handle on it and was able to perform procedures without any assistance and learned the importance of finding a good vein. The rotation allowed me to present cases to the PAs I worked with, how to properly work-up differential diagnosis, and the importance of trends when it comes to labs, just because labs are below or above the average range, it doesn’t necessarily mean the patient needs treatment but can be their baseline.

The highlight of this rotation for me was stroke week. It was exciting since it allowed me to gain hands-on experience with performing neurological exams on patients and what to look for when examining a patient with a possible stroke such as slurred speech, droopy mouth, pronator drift, and strength. I got to see a patient come in where code-stroke was activated, but had Bell’s palsy instead, and got to see how the forehead was spared. During rounds with the attending, and PA they showed me how to read MRI scans, and CT scans and where the stroke took place.

Internal medicine gave me the opportunity to see a plethora of disease states. Many patients I saw had arrhythmia issues, and pulmonary issues so I was able to hear murmurs, and hear the difference between crackles, and rales which is something I’ve learned so much about, and I finally got the chance to hear the differences. Internal medicine has set me up with a good foundation as it gave me great exposure to so many specialties, and I various disease states.