Tuesday, September 13, 2011

Transplant with Dr. Park - Part I

Posted by Bernadette at Tuesday, September 13, 2011

As the P4 class is going into the second half of Rotation 2, this will have to be a retrospective look on my first rotation, solid organ transplant with Dr. Park. This rotation is notoriously known as one of the more difficult rotations. From what I gathered from previous students before the start of the rotation, Dr. Park has high expectations and the amount of material needed to prepare for this rotation was, well, endless. Looking back at my experience, both those points were quite true, but while those were reasons why it made the rotation so difficult, they were also the reasons why I liked it and learned so much in my first month. With that said, this was in no way an easy rotation, but in my opinion, one worth trying to get.

Now there are things as a P4 you can do to prepare for this rotation, and there are things you simply cannot control. Example of things out of your control: your partner, your team (medical students, residents, fellows, attending, etc.), and your rounding hours. I was not the biggest fan of rounds starting at 5:45 am, but like I said, you can't control it. Surprisingly, when I began to follow and track the progress of my patients, rounds were the most energizing part of the day. The team is actively discussing each patient, and it's the time you start to consider the direction of your patients' therapies - do you continue their current medications, what needs to be added/dropped, etc. Unlike many other types of rounds, these are actually pretty quick and efficient - about an hour and a half for 20-30 patients. This also means you need to be paying attention; if the team is discussing your patient, have in mind their likely problems and how to resolve them, listen to what the team will be doing and start to think about why (there are lot of labs and tests to run, but if you don't know why they're being done or what the expected results will be, just ask!).

Overall, rounds are the best way to stay updated on a patient. Notes in the chart get posted late and aren't as descriptive and helpful as simply talking to a person. If you were the patient, wouldn't you want to just ask rather than read off your medical record? Also, it's the time when you have the opportunity to make your recommendations for your patient. Sometimes you will get asked for recommendations, and while the "look it up" cliche still holds, it does help to be familiar with general guidelines because most decisions are made on the spot about what medications to start/stop. Of course, if you don't know, you don't know - look it up after and if something does need to be changed, tell someone and make it happen.

...to be continued after rotation today!

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