Tuesday, May 1, 2012

You Can Check In Anytime You Like, But You Can Never Leave

   Today was the first real day of my third year of medical school.  I started on my psychiatry rotation, and for the first four weeks, I am at a "locked up" facility.  Basically, that means the patients are held there involuntarily, so they have pretty serious mental illnesses.  I wasn't really nervous until yesterday, when they gave us training on how to escape choke-holds and what to do if patients try to rip our hair out/bite us/etc.  Needless to say, I decided to wear my hair up!
    I'm not going to lie, it's pretty scary walking down the halls.  The patients are allowed to wander about and go where they wish, and as you walk down the halls, they stare at you, follow you, laugh creepily, etc.  I felt like I was in a movie or something.  It's pretty intense, but I absolutely love it so far.  I think the patients are so fascinating, and I really enjoy interacting with them.  Our offices have windows looking out to the courtyard in the middle of the facility, where patients are allowed supervised "outside time".  I found it a bit comical that its like watching fish in a fish bowl.  You have to be careful not to stare though, because they can see you through the windows!
    The one thing that frustrated me a little was that I have absolutely no idea what I'm supposed to be doing day to day.  I've heard that is the theme of third year.  I think that is something I'm really going to struggle with on my clerkships.  I am the kind of person who likes a little hand holding, and to be straight-out told what to do and when to do it.  I'll do anything I'm told, I don't mind!  But I hate when I have to try and figure out what I am supposed to be doing, especially when I am unclear what my role is as an MS3 on the team.  Unfortunately, it's a little different for each rotation and each site, so I can see myself struggling with this all year.  So that is stressing me out a little bit.  I think part of it is that I just want to do well, and right now, I don't really know what I have to do in order to do that.  I suppose I'll figure it out, everyone does.


  1. Congrats on starting third year! If you haven't figured it out already, each stage of med school is better than the previous- not without its own challenges, but much more rewarding, too. You'll be amazed at how much you can learn in a single rotation, even at 4-6 weeks... and then how you're back at the beginning again immediately after when you have to start something new. I'd encourage lots of (HIPAA-friendly) writing over the year, it's incredible to be able to look back and see how outlook and confidence changes in 12 months!

    1. Yeah, I really love to blog as an outlet to move my thoughts from "buzzing around in my head" to "written down somewhere". I have been wondering a lot lately about how to go about blogging in a HIPAA-friendly way. Do you have any suggestions? Or does anyone have any good resources/articles that talk about HIPAA-friendly writing?

    2. From what I've seen people in healthcare do, I think you have to put a disclaimer that you vow to protect people's privacy. Obviously change names, any identifying information about a facility where something happened, any specific diagnoses that *might* identify that patient, etc. So think of it this way: if I was a fellow student who was reading your blog, would I be able to tell you're taking about THAT patient we took care of together? If I can, then you've given too much info. What I've also read is people who really CAN'T change too much otherwise the story loses "spice," they simply ask the patient if their story could be used for teaching purposes/to the public, etc. I've had to ask before as a nursing student and have not had a problem. One of my doctors used me as a case presentation and didn't even ask me (I found out from a curious med student! haha), but I didn't mind. Good luck!

  2. I haven't done my psych rotation yet, but I'm quite nervous for it as well! I have a couple of friends who were cornered or attacked by their patients, so needless to say that scares me a little.

    As for not knowing what your role is, I think that's a universal third year occurrence.
    The best advice I have is to read through every patient's file, know their story and read up on their cases.
    It also doesn't hurt to ask the consultant what they consider your role to be, but some of them might not know either. Not all doctors take too well to being teachers it seems.

  3. You'll get your feet under you soon enough I bet. Lots of time to observe and learn, sounds like....