Day 1 of the sub-internship

Today I started my sub-internship (sub-i) on the Infectious Disease service at OSU. Everyone kept asking me why I'm doing my sub-i so late in the year, as most fourth-years do it early to get letters of recommendation, but because of my early match and the fact that my paperwork was due early, I had to do my Army obligations and preventive medicine rotations at the beginning of the year, when most people were doing their sub-i's. Of the 200+ fourth years, there are only four of us doing internal medicine sub-i's (there are four choices: internal medicine, surgery, OB/GYN, and pediatrics) this month. The other three are all going into radiology, so they were in the same situation as me (kinda): they were too busy interviewing and doing radiology rotations to do a sub-i, which isn't in an discipline they are interested in.

Anyway, so a bit of an explanation on what a sub-i is. It's a waste of time. All snideness aside, in theory it's a chance for us to practice being interns before we actually are interns. In theory, we are the primary physicians for 4-8 patients on our service (the infectious disease service has 12 or fewer patients). That means that the nurses are supposed to page us with questions and updates on those 4-8 patients and we're supposed to put in the orders and all progress notes and discharge information.

Now, that's all fine in theory, but let's talk about practice. Legally, medical students can't put in orders, can't write progress notes (well, not progress notes that count), and can't admit patients (another thing we're supposed to do). So, if sub-i's do everything that we're supposed to do in theory, we'd actually be doubling or tripling the work of our residents and the real intern, because they'd have to check over all the orders that we want to put in and correct them, they'd have to re-write our notes, and after the nurses paged us with updates on the patients, we'd have to page them to ask for permission to do anything (including put in the orders that we can't legally put in).

So back to my day. I got the hospital at 7 (a bit later than usual for an internal medicine service) to meet with the resident and intern (both of which are going to be switching to new services on the first of April). There are also two third-year med students, which will make the whole being-a-sub-intern interesting. I spent the morning rounding and trying to learn things about the patients, and then had orientation at noon (which is where I learned about what we're supposed to be doing and learning how do this month). Then after a few hours of pointless orientation, I came home. A terribly thrilling day, I know. Unfortunately, I forgot to ask what time they wanted me in tomorrow before I left... Oh, well. These won't be the residents who will be evaluating me, so it doesn't really matter :)