Yesterday I started my block 4 (of 13) rotation: ambulatory (out-patient) medicine. In other words, clinic. Lots and lots of clinic, a different one every day.
I started in the Medical Evaluation and Treatment Unit (METU, because everything has to have an acronym), which is for internal medicine patients who need medical clearance for surgery or have simple procedures (such as a joint aspiration) that has to be done. I had two patients in that clinic, both for medical clearance for surgery. Those are pretty simple: just go over their risk factors, most of which are cardiac (history of heart attacks, strokes, etc) and the risks of the surgery (an arthroscopic knee surgery is a lot less risky than an open abdominal surgery), to determine their overall risk and if they need any further testing before the surgery. Both of my patients were low-risk for medium-risk surgeries and didn't need any further testing. Seeing the patients took about five minutes; writing a note on AHLTA (the DoD's electronic medical record system) took about forty-five minutes. I hate that system.
Then I moved to the General Internal Medicine Clinic (GIMC, pronounced gem-see) in the afternoon. Since I don't have a group of patients that I see on a regular basis, I get all the walk-ins, which are very simple cases. I had two yesterday that both came in with "I used to take ___, can I have a prescription for that again?" to which I said "sure, why not?" Then the third patient was a specialist who pulled a muscle playing flag football the day before. He got ibuprofen and a muscle relaxant.
Today I started in back in the GIMC, where it was more of the same--simple cases, followed by spending a long time trying to write a note. The afternoon was spent in the optometry clinic, which is pretty much just learning what they do there and what cases should be referred to optometry and which are ophthalmology issues.
Tomorrow... I have no idea. I guess I'll figure it out when I go in and check my schedule in the morning.
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