Learning to Be Flexible (21/30)

Alarms for my week of general surgery

     When you start clinical rotations, you’re prepared (at least in theory) for certain difficulties. You don’t know your schedule ahead of time, though you know that it will change every five weeks, the emergency medicine rotation will likely have odd hours, and you will probably have to wake up very early for the surgery rotation. You’re told that you will likely feel like you know nothing at first and that any time not actually spent at your rotation site will probably be consumed by studying. You know that some rotations will be better than others, but that even the worst ones will end. Then the first day comes, you take a deep breath, and you step into a new realm of uncertainty. It’s not just for the first rotation either; each rotation is different from the last and while you may quiz your peers on what to expect, you still face each first day of each rotation with a blank slate and lots of questions. What does your preceptor expect from you? What are the typical hours? Are there typical hours? Will I be quizzed constantly? What will the other students be like? Will patients refuse to be seen by me? What if I completely botch a procedure? What if I forget all the medications I ever learned? And on, and on, and on... The truth is, the questions never really stop, they just change into new questions. By the time you finally start to feel comfortable at one rotation, time’s up and it’s time to go some place new.

Before going into an appendectomy at 11 AM, and then later at
midnight, with at least 7 hours still left to my overnight shift.

     The key to keeping sane sometimes is to just be flexible. Some rotations will never give you a clearly defined schedule and you just have to live day by day. For some rotations your preceptor changes daily, so you’re constantly adjusting to new and different personalities. For some rotations you realize that the experience of your peers might vary vastly from yours, sometimes based on what seem like tiny details. For example, I am currently on my surgical rotation, which includes an overnight shift during the week of general surgery. The thing is, because I’m in general surgery first, my “week” is actually one day longer than the other weeks of this rotation, so there is a definite possibility that I may have to do one more overnight shift tomorrow, even though I already did one last week. I will admit right now that I am not thrilled about this prospect, particularly since the “overnight” shift actually goes from pre-rounds (5 AM) of one day to post-rounds (approx. 7:30 AM) of the next and sleeping rarely happens, but if it has to happen, it has to happen. Rolling with the punches and adjusting expectations is just part of the clinical year. 
     I’ll probably do a post in the future about some of the other difficulties of the clinical year that don’t often get discussed (What if your preceptor is a bad teacher, or worse, a bad clinician? What if the preceptor for your next rotation decides to reture? What about all the non-rotation related things that can cause problems, like cars or living situations?), but right now I need to grab some lunch, read up on laparoscopic cholecystectomies, and attempt to get the electricity account transferred from one roommate to the next, so it's time for me to sign off.

UPDATE: a kind medical student volunteered to take the overnight shift so I didn't have to do another one. It was only later that the chief resident informed us that a student wasn't necessary for every overnight shift anyway.