Following the other 14 rotations, finally I come to the end rotation, which is general internal medicine. The department of general internal medicine is the core of medical education itself. Treating various conditions in adult and geriatric patients, internal medicine ward covers 60% patients in the hospital besides pediatrics.
The internal medicine clerkship consists of junior and senior clerkship phases. Junior clerkship deals with internal medicine wards, assessing new inpatients with internal medicine residents. Student doctors performs various tests such as physical examination, electrocardiography recording and vital signs monitoring. We also assists residents to make sure various patients’ programs work, such as vital signs observation, nebulization, electrocardiograms etc.
Senior clerkship mostly focuses in emergency department, dealing acute disorders, and exacerbation of patients with chronic diseases. Sometimes attending physician comes and discuss diseases with the residents and clerkships.
In the morning, all senior and junior students gather with attending physician to have morning report. We discuss chosen case (mostly chosen by resident), from history-taking, physical examination, laboratory/ecg/radiology findings, and assessments. Assessments are the core of this morning report.
In the mid-day, students will have bedside teaching with each divisions
Cardiology: During this bedside teaching with cardiology fellow (a senior internist who undertakes cardiovascular medicine specialty), we discuss about cardiovascular examination in a patient with heart disorders. How to do an effective history-taking, and finding the appropriate disorder, choosing the right .
Pulmonology: Internist-pulmonologists introduced us to several kind of pulmonary patients such as COPS, pulmonary tuberculosis, pulmonary masses, and brought us to a discussion about how to diagnose a patient with pulmonary symptoms.
Gastroenterology and Hepatology: Internist-Gastroenterohepatologists explained to us about history taking of an icteric patient, how to do a physical examination to a chronic liver disease patient, and laboratory findings related to the liver function tests.
Nephrology: I was the only medical student in this bedside, I almost had 5 days in 3 weeks of bedside with a very senior nephrologists, she took me to all her patients and I was so touched to know this. At the end of the bedside, I asked her permission to have examination and she blessed me “good luck, and be a good doctor!” she said.
Rheumatology This is also another interesting bedside, with discussion of arthritis, SLE, scleroderma and ended with a practical OSCE.
Hematology and Medical Oncology A big evening round in oncology ward
Tropical Medicine, Infectious Disease and Clinical Immunology I am assisting my professor to find Tetanus, HIV patient, due to an exchange medical student from Japan came. And we have a morning round together.
Geriatrics a case presentation with geriatric assessment
Endocrinology, Diabetic, and Metabolic A day round about diabetic foot with a diabetic foot specialist. We were taught to measure ankle brachial index.
I am so happy to end this clerkship with all my passion, and continue to comprehensive clerkship in Karimunjawa Island and Donorojo Lepra Center/Kelet Hospital.