a bit of a non-sequitir: a friend was over at the crib a month or two ago, and we were talking about my very slowly progressing medical schooling. he asked what i wanted to go into, i said "pediatric oncology," to which he laughed his ass off. i was a bit taken aback by this, and after a moment stated "look, it's really not that funny. actually it's about as far from funny as it can be." and he looked at me, stopped laughing, and gave a puzzled look. "dude. you can't tell me you want to go into pediatric gynecology and not expect me to laugh." true story.
ANYWAY. the way this rotation works is that it's 6 weeks, and every week they move you to a different location for a different specialty. right now i'm in gynecology/oncology, which encompasses cervical, endometrial, ovarian, vulval and vaginal cancers, for a start. basically it involves a whole lot of time in clinic, following up surgery and chemo patients, and also a lot of time in the OR. yesterday i spent 5 hours watching a laparascopic lymph node dissection and radical vaginal hysterectomy. it was pretty cool. basically they removed this woman's uterus and only made 4 tiny incisions in the abdomen, two of which were simply covered by band-aids at the end of the operation.
so the OR bit is cool. clinic is a bit slow. since i'm only a 3rd year med student, they don't want me dictating yet (the 4th year gets to though). so that means i can't go see patients on my own, only with the 4th year or a resident or the PA -- because whoever sees the patient, dictates the note. the way clinic works is, you see the patient and perform an external exam, staff (review the case) with the attending, go back in with the attending and finish the exam including pelvic/bimanual, then dictate the note. THEN go see the next patient. and so on. there is about 30 minutes blocked for each patient, and there is at least one resident and the PA available to see patients at all times, so in all theory everything should go pretty smoothly and patients shouldn't wait longer than a half hour or so.
well let me tell you about this resident i worked with today (and on monday). remember those commercials (i think it was chili's) about those ginormous burgers that were "monuments of inefficiency"? that's this guy. except without the delicious fried onion rings and twice as irritating. he is SOOOOO slow. today he was averaging about 30 minutes with the patient, 45 minutes to dictate. seriously. this guy would say a sentence. pause. think. read the chart. rewind. restate sentence. pause. think. read the chart. next sentence. pause. think. etc. IT WAS PAINFUL. the nurses had me go see a patient today (defying all rules! shock! awe!) because he took over an hour dictating one patient, and we fell over an hour behind. and that patient i saw, she bitched me out for taking so long to see her. like i could do anything about it. (what, you want me to turn back time and be more efficient? lady, what do you want me to do?) she ended up walking out while i was staffing with the attending. the nurses, bless their hearts, blamed the resident for being soooo sloooow and i was championed as the scrappy lil' student that tried to pull us out of the muck. (that was pretty sweet)
whew. glad to get that off of my chest. yeah so this resident is a schmuck. well, not really. he's not a jerk or anything. he's just slower than, oh i don't know, slower than some really slow shit. i hate inefficiency. i'd almost rather have him be a very efficient asshole. (sort of like my attending.. that's a different story).
this educational lesson brought to you by dr. j around 9:08 PM |
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