Rotation: Bone & Joint Infectious Disease (IM Subspecialty)

Name/Location of Clinical Rotation

Internal Medicine subspecialty (2 weeks)–Bone and Joint Infectious Disease

Typical Day:

I’d arrive around 7:30am after taking the Ladybug to daycare. I’d see a few patients, write my notes, and meet up with the team at 9am to round. Rounding would take a lot of time and we’d see a fair amount of patients. Afternoons were reserved for clinic on Tuesdays and Thursdays, and sometimes we’d see patients til 4:30-5pm or later. Other days, I’d get to leave for the day once all the work was done, sometimes as early as 2:30pm. Since I was on Infectious Disease, there were plenty of cultures being sent, so I got to go down to the microbiology lab to look at slides and have them read. I also really liked my team. Sometimes I’d get to go with the pharmacy students to presentations and journal clubs, and I even got to share some of my micro/immuno Step 1 mnemonics to help them as they studied, too. It was nice to teach for a bit, while also learning something new.

What did I like most about this specialty?

We actually got to see a lot of cool pathology. Burns and traumas were interspersed among our diabetic foot ulcers and pneumonias. I really liked working with the adults we saw on this service; they seemed to really like having a med student to talk to, so that was fun. (And then sometimes, on my way into the hospital, I would run into my patient outside, smoking, and I’d say, “Hey, I’m going to see you soon in your room, ok?” Sometimes that would work to get them back inside.) 😉

What did I like least about this specialty?

Sometimes I felt like the work was a bit too repetitive…. Vanc/Zosyn for everyone!  (Or at least, that’s how it felt some of the time.)

Did this clinical rotation give me a good sense of what practice in this specialty would be like?

I’m not really sure; we saw inpatients and we also had clinic, so I felt like I saw a good mix of patients.

Did my interests, values, skills and personality fit with this specialty? If yes, how did they fit? If not, why might they not be compatible?

Yes. This was another service where I felt like it was valuable for me to sit and talk to patients after my work was done. I enjoyed the patients, the learning, and getting to be useful.

What are the possible practice settings exist for this specialty? Do any of them interest me and do I know enough about them?

I’m thinking that I really want to work in a hospital long-term, so knowing that I could do that in this subspecialty felt like a “fit” for me.

What info do I still need?

I’d still like to get more experience with other rotations to give this one a fair comparison.

Has my perception of this specialty changed? If yes, how?

Around this time, I felt like I hit my stride with adult patients. I was learning to take better H&Ps on this service than on Cardiology (on Cardio, we basically just cared about heart/lung issues) where on this service, I got a lot more practice taking full histories (especially on clinic days with brand-new patients!). I’ve thought about Infectious Disease before (because chasing down rare illnesses like Ebola sounds like fun straight out of The Hot Zone, right?), so it was fun getting to actually see what it was like.

Did my clinical rotation experience influence the likelihood of choosing this specialty?

I actually enjoyed this rotation more than I thought that I would, so it’s still on the radar for the future.

Right now, how interested am I in this specialty?

Maybe a 7. It’s still Internal Medicine, and I’m still excited to see other specialtes, but I can say that I definitely enjoyed my time here.

What information do I still need to evaluate this specialty? Any other comments or reflections?

As a part of this team, we got to work with a small group of pharmacists and pharmacy students, which I hadn’t seen used elsewhere, but made a great addition to the team. We also had clinic twice each week, once for the HIV clinic and one for the Bone and Joint clinic. Both were a lot of fun. I actually really liked getting to go to the clinics. I got to help out with interviewing the patients and performing physical exams, changing dressings, answering questions, reassuring worried patients, etc. (Have I mentioned that I really enjoyed clinic days?!)

Pro tip–keep a roll of tape with you, because you’ll be putting dressings on a lot of joints and it saves time. The attendings love you if you do this one small thing to be helpful–yay, efficiency!

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