The United States Medical Licensing Exam has three steps: Step 1 is between the second and third years of medical school, Step 2 (which itself has two parts, CS and CK) is at some point before medical school graduation (I did mine July 2008), and Step 3, which is sometime after graduating medical school and before becoming a licensed physician (for most people, during internship).
Like Step 1 and Step 2 CK, Step 3 started with a seemingly endless series of multiple-choice questions on the computer. That was day one. Then, on day two, more multiple-choice, and then patient simulations--ridiculous cases on the computer where real time and case time aren't the same. It's really confusing to try to explain how it works, so we'll stick with, it was strange.
And now, I have to wait six weeks until I find out if I passed or not.
Anyway, I returned to the Infectious Disease service today (in my Class B uniform, because I forgot to wash my ACUs... I discovered today why I haven't worn those uniform shoes since the first time I wore them. My feet are killing me). Anyway, on Fridays, its all the same on consult services. Realizing that consultants don't do much on weekends, all of the primary services (the doctors on the wards, the ones writing the orders) will put in any consults that might need to happen in the next three days. So, on pulmonary services, it's "patient has lungs, please evaluate and treat", and on ID, I guess it would be "patient once complained of having a fever, please evaluate and treat". So we got a few consults like that.
The first one was "patient had a fever, chest x-ray looks like pneumonia, please assist with antibiotic treatment." This is actually pretty simple: you open the books to 'Hospital Acquired Pneumonia' and pick the antibiotics listed; then, when the bacterial cultures grow (usually takes 2-3 days), you figure out exactly which antibiotic is best, so you take them from getting two or three antibiotics, down to just one. So our recommendations were, "Continue antibiotic regimen, when culture and sensitivity returns, tailor antibiotics as necessary." Pretty simple.
The next one went to the med student (pretty similar to that one), and the one after that was mine. It was a little old lady with multiple cancers (colon, lung, esophageal...) and something on her chest CT. So we pretty much just gave advice about what they should test for.
And then we wrote our notes and went home (where I finally got to take those shoes off). Time for a nap.
No comments:
Post a Comment