Internal Medicine Rotation Expectations
Michael Galibov, DO
Ah yes, Internal Medicine (IM). A pillar that promises you will spend lots of time at the hospital. I remember as a third-year medical student being very intimidated by the concept of IM, not knowing really anything of the day-to-day proceedings of an inpatient-based hospital team. I knew some words, like rounding, pre-rounding, attending, and admission but no semblance of how they all fit together. However, IM turned out to be where I grew the most as a student. The goal of this post is to explore your role on the team as a third-year, a fourth-year, and even some recent reflections I have as a transitional year intern.
IM can be so variable depending on where and when you rotate, but ultimately, I thought of it as a pattern that I had to figure out and find my way into. As a third-year, you will likely “carry” only a few patients, but it is expected you try to know every single thing about them. What they had for breakfast, who their favorite musical artist is, anything is fair game - but seriously, you don’t quite know yet what is important and what is not. Better excess than far less. The pattern I alluded to ends up being something like “get there early, pick some patients, round on your own, update your resident, round with the whole team, get asked some questions, write some notes, send some people home, and see if anyone new is coming.” Rinse and repeat.
By understanding how the day will go, you can see how much time you typically need for each step of the process. Some people are faster than others - this doesn’t matter, find what works for you and stick with that, ready to simply absorb information.
As a fourth year, especially if you’re doing an audition, the onus is on you to now not only carry more patients but also have some foundation of a plan. You don’t have to be right, but it behooves you to be at least in the ballpark. You’re looked at as someone who is a bit more reliable and may be tasked with some more activities by the interns and seniors. You’re doing your best to humbly showcase that you would be an awesome resident.
Then, once you become an awesome resident, like me (ha), not only are you responsible for the duties expected of you, but you should make an effort to involve and teach the medical students that may be working with you. I still remember some of the lessons that a resident presented to me when I was a medical student, taking time away from what they had to do to make sure I understood a concept that might come in handy for me later in my career. It’s only fair to pay it forward.
All in all, IM is a dynamic field that promises to challenge you and keep you busy. But, once you find your stride, the hours fly by.
