You know working in the hospital allows you to work with different students with different interests.  One of the differences of interest is the type of devices you have to use in order to communicate.  Some students have an Android device while others have an iPhone device.  And group texting is a pain when majority of the people you group text has an iPhone and there is one or two persons who have an android.

iPhone's iMessage allows anyone with an iPhone to group text on 4G or Wi-fi and it's simpler.  It doesn't work for someone Android devices.  Therefore there is this app for both iOS and Android called "WhatsApp".  This app allows people with any device to group text or group chat together and share files flawlessly.

This works via data so if you have a data plan or wi-fi then this would be perfect for your use.  This app was very useful in terms of getting groups together during my internal medicine rotation.  Internal medicine by itself is intense and requires alot of attention and so you don't have time to deal with other things.  You also need constant communication with your team to get the work done before your attending doctor shows up for rounds.

Also, I'm not getting paid to promote this app, I'm just writing this post in order to help the medical students be more efficient during rotations.

I know this may be confusing to some but it’s very simple once you fully understand the difference. A hospital that has a residency for a certain program will have a green book status for that particular rotation. And if there are other rotations then it will fall as a blue book.

For example, for Jackson Park Hospital, it has a family medicine residency program; therefore, the family medicine rotation for medical students counts as a green book rotation. However, the internal medicine rotation at Jackson Park Hospital counts as a blue book because the hospital does not have an internal medicine residency program there. Other core rotations count in the same category such as Psychiatry, OB/GYN, Pediatrics, and Surgery.

If you want to go for Internal Medicine residency then you may want to do your Internal Medicine clerkship at Mercy Hospital instead of Jackson Park Hospital. Some residency programs prefer their applicants to do all their core rotations with a green book status; however it’s not universal so don’t worry about it. The reason I say this is that a lot of FMGs get residency programs in IM but they have no US clinical clerkship experiences. With SJSM you have 80 weeks of US clinical clerkships so that’s why you shouldn’t worry about it.  The same goes with other non SJSM Caribbean students, they have 72 weeks of US clinical clerships.

This post will highlight the core foundation of all the rotations in the 3rd and 4th year of medical school. Internal medicine (IM) is the rotation, which should not be taken lightly. According to a friend of mine, from Ross university medical school, and according to some doctors, the IM rotation in Jackson Park hospital is one of the best in Chicago. This does not mean that other rotations are as good but internal medicine rotation is one of the best. IM rotation is one of the most hands on experiences you will get if you are assigned at Jackson Park hospital. You will do all sorts of procedures and see so many things such as hernias, gangrenes, amputations, MRSA infections, lumbar punctures, etc. I have seen so many things and I learned a lot from hands on experiences. When I look at the lab I know what to look for and how to narrow down my differential diagnosis based on lab values and symptoms. Obviously, I’m not an expert in diagnosing patients but I learned a lot in the 12 weeks experience.

In Jackson Park hospital, the group of students is split up in six groups. Each group is assigned one of the 6 attending physicians and they rotate every 4 weeks. Each 4 weeks counts as a block and everyone has to have 3 blocks. The 6 physicians are Dr. Kumar, Dr. Murthy, Dr. Iyengar, Dr. Ali, Dr. Hussain, and Dr. Khan. You will be assigned three of the 6 doctors in the 12 weeks period.

Dr. Murthy

He is the medical education director and he gives a final say on your IM grade. It’s very important to get on his good side because of the letter of recommendation that he will give. He is not aggressive like other doctors but he can put you on the spot if you ask him to leave early. He is known to tell his students to “Google” everything. His students will have their smartphones battery drained after rounding with him because he expects everyone to look up answers to questions he asks. A friend of mine told me that Dr. Murthy had one student who didn’t have a smartphone, so for that Dr. Murthy told him to leave; lol.

Dr. Kumar

He is one of the hospital’s cardiologist who prefers to have 8 students per block. He is not the happiest physician you will meet, but he is extremely knowledgeable. Dr. Kumar will put his students down if they answer wrong questions. He is famous of making a large “0” with his fingers in front of the student when that student gets something wrong. And he will pronounce it in an Indian accent “jeero”

Dr. Khan

This guy you would describe him as a G. He’s ballin with great hair and a smooth way to talk. He didn’t even know me and he randomly sat me down with few other students and started giving me advice about life. He’s an easygoing doctor but he expects you to try to do some research when he asks you about a certain medical question.

Dr. Ali

He is a very polite and humble Indian doctor. All his students like him because of his gentle attitude. If you make a mistake, he will forgive you and advise you to try to avoid it next time. He is the most wanted attending physician in the internal medicine rotation because of his easygoing ways. However, sometimes he seems to be intimidated by multiple things in the hospital so he may mumble while he’s speaking.

Dr. Hussain

He is a polite physician but it is very irritating when he doesn’t show up on time. Dr. Hussain is not the best when it comes to showing up on time.  He wants everyone to send emails to him regarding what he taught for that day so they are on point on what they learned.

Dr. Iyengar

Rotation under this physician is new so I can’t say anything about him.

Presentations

The presentations in IM are so exhausting. We have to present to Dr. Kazmi and he is not the most polite or easygoing doctor you will meet. This doctor will come off as someone who will tear you apart on the first day but through the IM he calms down if you do your presentations on time. At the end of IM you will have to take a test on all the presentations you and your peers presented. The test is insanely hard because no one has time to study for it due to on-calls and rounds, which are tiring.

On-Calls

On calls are usually fun with moderate number of patients but other times it’s irritating when there are a lot of patients coming in the middle of the night. During the previous IM batch everyone had to do 24 hour on calls with breaks within those hours; however all that has changed with the new batch. Nowadays, there are 12 hour on calls which was changed by Dr. Kazmi. And if anyone intentionally is absent during presentations, then they are penalized with an extra or two on calls. It got brutal each time a new batch starts.

I hope this post helps in your preparations for Internal Medicine rotation at Jackson Park hospital. I wish someone had posted something like this before I started internal medicine, it would have helped me a lot.

Psychiatry in Jackson Park Hospital is one of a kind with a lot of inpatient exposure. Most of the patients, who stay longer than a week, are diagnosed with schizophrenia or some kind of drug overdose. You will also see patients who are found on the streets because of alcohol overdose.

After going through the psychiatry rotation I am very confident that I do not want to go into psychiatry. The reason being is that getting the proper information out of the patients is like finding a needle in a haystack. The patients are either on Haldol, so they are sedated, or they are aggressive and uncooperative.

The psych ward is located in two different sections the 4th floor of the east wing, hence 4 East, and the 4th floor of the South wing, hence 4 South. The 4 East section is the area the men are and the 4 South is the area where the women are. The separation is mandatory to restrain the patients from having any sexual conduct with each other and for their safety. Another safety protocol is that students should attend the patients in pairs. If a male medical student checks up a female patient then a female medical student is to be present and the same goes for female medical students checking up male patients.

When you go through the psych ward you see some patient in a state where you feel bad for them. And I see the hardship they went through that got them to be where they are. And what I saw made me appreciate who I am and what I have compared to the state the patients are in.

There is so much frustration during rotations. Some attending doctor hardly gives us time to do our other work that we are supposed to do in Internal Medicine rotations. It’s irritating that they keep us waiting for them for hours so we can round. Unfortunately this is the way of clinical clerkships as we have to do everything the doctor tells us to do as he/she has the final say in our grades.

I am hardly getting any time to study for my USMLE Step 2 CK. My advice, for prospective students who are going to start clinical rotations, is to start studying for Step 2 CK immediately after passing the USMLE Step 1.

I attempted to study in the hospital but with all the hectic activity that it’s so hard to. In the day room where it’s separated from the patients there are medical students walking around because doctors use them as free labor. Then there are nurses running around and yelling and then there are resident doctors who require medical students to do new H&Ps on new admissions. So it’s just pure hectic lifestyle in this 12 weeks of internal medical rotations.

Hello hello, it’s been a while since any posts have been made and trust me I’ve been very busy with rotations and so that’s why things are hectic. I am in rotations currently and I love it. I never thought, as a medical student, we could be as invasive as possible during rotations, but we are.

Last year when I was studying for USMLE Step 1, I always talked about what it would be like to be in the position I am right now and now here I am, thank the Almighty. It’s a great feeling that you are now considered a doctor, even though you don’t have the title, you are a doctor after passing USMLE Step 1.

When I was working at the nursing homes for my Family Practice rotations, a nurse comes up and starts off calling me a doctor. I stopped her before she can say any further and told her that I am only a medical student. She continues and tells me that it’s the same thing since we do what the doctor is supposed to do. Apparently, we spend more time with the patients than their real doctors. We medical students listen to the patients, conduct the physical examinations, and report what we find and the labs we get to our attending doctors. The doctors will then see what our finds are and spend couples of minutes with the patients and then he will make the assessments and plan for treatment.

Unfortunately, it’s heartbreaking to see the pain and suffering of the elderly at the nursing homes. The elderly are there because their own families cannot take care of them because the elderly requires oxygen and constant monitoring that they need to be there. Sometimes I think what happen to the old days of taking care of one’s parents in one’s own home. Our parents raised us from childhood and took care of us when we were young so it’s our obligation to take care of them while they are old. The ground reality is, the children of the elderly residents of the nursing homes are not from good socioeconomic places so they have to work and cannot attend to their parents.

I’m learning a lot about people and how to take care of them while being in rotations. However, it’s not helping me as much for the USMLE Step 2 CK. It’s only helping me for the USMLE Step 2 CS because we have to do H&Ps and progress notes and make diagnosis from what we find.

It’s one thing to do a doctor’s work but it’s another thing when you diagnose something right without the doctor looking over your shoulders. Yesterday, the doctor sent me to do a full check up of a new admission on a female patient with a past medical history of hypertension and asthma. When I did a full check up I heard something abnormal while listening to her heart. I thought I was wrong but then I figured that I may not get the diagnosis right but I was confident her heart sound wasn’t normal. I went to my attending doctor and I suggested that she had a systolic murmur based on what I heard and also based on her past medical history of having hypertension. The attending doctor came in and listened to her as well and he confirmed that it was a systolic murmur also. He ordered an echocardiogram to see the intensity of the murmur.

Reading about it and answering these clinical questions correctly seems like a burden to pass the board exams; however, when diagnosing a patient with a real illness it feels exciting. Now don’t get me wrong, I don’t feel good about the patient having the illness but it’s a satisfying feeling figuring out the specific murmur out of the so many murmurs.

For those who are still studying for the USMLE Step 1, this is just the beginning of what you are studying for. Make sure you study well and know the clinical scenario for each diseases because you may run into such when you start your clinical rotations.

As you know for the AICM 5th semester, we have 8 weeks of introductory rotations to complete. And within these 8 weeks every student is required to complete 4 on-call shifts: 2 for Internal Medicine, 1 Family Medicine, 1 Surgery, and 1 OB/GYN. For me AICM is completed and as I prepare to head to my home state I found a little time to write this post to give prospective students a heads up on what to expect.

Internal Medicine

For IM, we have to do one shift in a weekday and another in the weekend. In a weekday we have to complete a shift from 8 PM to 8 AM the next day. On a Saturday or Sunday we have to complete a shift from 8 AM to 8 PM. During the weekday shift, it’s was tough for me, since I have to stay up all night. On my shift I had to take history and physical for a new patient and present the case to the on-call resident who’s on the floor. He doesn’t go to the patient, instead he listens to what I got from the patients and he looks over the patient’s charts. Most of the times the nurses on the floor will take care of the patients who are admitted while the medical students and the residents joke around and goof off in the residents room. During the night, each medical student will take turns to sleep for couple hours or more while the other students admits new patients or check up on other patients who are already admitted. I can’t sleep in the hospital so in order for me to drive home safely I consume as much caffeine as possible so I can drive home awake. After my shift was done at 8 AM, I had to attend the morning report which lasted till 9 AM.

Family Medicine

In this rotation, we have to come in during the day to complete our duties in the Family Medicine clinic. After the clinic closes, which is around 4:30 or 5 depending on the day, we have 3 hours to do whatever we want. At 8 PM we have to join the Internal Medicine students and basically do Internal Medicine on-call shift. And just like Internal Medicine, we have to show up for the morning report.

OB/GYN

This is one of the most boring shifts I have ever had. It’s not that the OB/GYN rotation is boring, it’s just that there isn’t many patients admitted to OB/GYN for us students to see anything. OB/GYN and Pediatric students are side by side because the nursery is in the OB/GYN area. The on-call shift for this rotation is from 8 AM to 8 PM.  I went to the OB floor and put my cell phone number and name so the nurses can call me whenever they need me; it's mandatory. After attending the morning report, I had to go to the Family Medicine clinic and sit with the attending while a senior student reads his/her presentation. After his/her presentation the attending explains the topic presented form his/her experiences.  Afterwards, I went to the floor of the clinic and helped out the residents till the clinic closed.  For the rest of the day I go to the Internal Medicine floor and the OB floor back and forth.  During my on-call shift there were two ladies who were in labor but there were a lot of students around so I didn't stick around much, I went to the Internal Medicine floor.

Surgery

The surgery rotation is another boring rotation since you don’t do anything. You basically stand back and watch patients in surgery. Most of the appointments are not even surgeries, they are nothing but colonoscopies.

What is a morning report?

The morning report is a routine seminar everyday in which a resident presents a case in front of medical students and an attending and describes how he/she diagnoses the patient. After the resident completes his/her presentation, the attending takes over. The attending, which can be any doctor, goes further in the subject and explains the case and the cause of illness of the patient. This seminar takes roughly an hour or so to complete. Within that hour you will see other residents and medical students eating their breakfast or checking their FaceBook on their iPhones, or whispering about what to do in the weekends.

Is there any attendance rule?

All students scheduled for the on-call rotations have to have an attendance sheet signed by a resident or an attending after the on-call shift is completed. The education office of the hospital will also give out three meal tickets per on-call shift which accumulates to $15 in lunch/dinner or $9 in breakfast. At the end of the semester the sheet must be turned in along with all the other paperwork and assignments to the education office. The medical office will give each student a grade and submit that grade to Saint James Medical School which will count for rotations.

Dress Code

Medical students on their on-call shift will have to wear scrubs. These scrubs are given by the hospital. And no, you don’t have to pay anything extra for them.

As you know AICM is mandatory for our class. I want to go over what to expect so you’ll get an overview of what’s going on. The pre-clinical program is divided in 8 weeks. The first 2 weeks has to do with preparations for the clinicals. The first week has to do with labs, which includes practicing injections in dummies, nasogastral tube insertion, catheter insertion, etc. The second week deals with EKG and orientation for the clinical. In this week there is no fixed schedule, you have to show up when the doctor shows up and the worst part is if you come to the hospital after an hour and a code yellow occurs then you have to leave and the orientation is cancelled, fun huh? It’s very frustrating and time consuming.

For the rest of the 6 weeks you will be split in groups for your rotations. The rotations include:

1. OB/GYN
2. Internal Medicine
3. Family Medicine
4. Surgery
5. Pediatrics
6. Psychiatry

Our On-Call schedule are as follows:
Internal Medicine – 2 Shifts
8 PM – 8 AM Weekdays
8 AM – 8 PM Weekends

Family Medicine
8 PM – 8 AM Weekdays

OB/GYN
8 AM – 8 PM Weekdays

Surgery
8 AM – 8 PM Weekdays

While doing the rotations you will also be assigned to do presentations on a topic classified within the rotation. Also during rotations you have to complete 2000+ questions from a desired QBank. It’s a lot of materials they throw at us and unfortunately they expect us to study well for USMLE Step 1 while being on this hardcore schedule. So, my advice for all those of you still in Bonaire and Anguilla, prepare yourself.

One of the students of MD4 got in contact with the SJSM students who is in AICM; so far we got an idea of how AICM is going to be. The schedule shows that we are basically in the front lines of clinical treatments in the hospital because we will be watching everything live.  The schedule is something like this:

9 AM – 1 PM
USMLE Step 1 Review – First Aid Book is the outlines

1PM – 2 PM
BREAK

2 PM – 8 PM
Rotations

And we get 2 on-call shifts during the week. That means we cannot leave the hospital and we get called anytime of the day, even at 3 AM in the morning. I heard we have to sleep in the doctor’s lounge when we want to sleep, but it’s not going to be the regular 8 hours of sleep I guarantee you that. So overall we’re getting a little taste of residency but without getting involved.

Dress Code
I don’t know about the girls but for the guys we have to wear dress shirt and tie, basically the whole formal wear. And we have to wear it 5 days a week. The only time we wear scrubs is during our on-call shifts.

The schedule looks pretty intense since it looks as if we’re in the hospital all day. Someone also said that you have rotation only 8 weeks out of the 16 weeks but I could be wrong. However, if that’s the case then I’ll have time to study for USMLE Step 1 in the 8 weeks when I don’t have rotations. I’ll be honest I cannot study in the classroom with an instructor lecturing me. I have to sit down in a silent room with a book and read the materials myself.

One thing I’m happy about is, these 16 weeks counts for the 96 weeks of rotations we have to complete in order to get our MD degree from SJSM. And when we review for USMLE Step 1, it counts for our rotation weeks, which is just great. Although, I’m not too excited about staying in Chicago, because I heard during the months of January to mid-March the weather is pretty bad. Chicago gets a lot of snow during those months. My Canadian classmates won’t have a problem though since they’re used to the snow and cold but I’m from a Southern state where snow comes one time every 3 years. And in the South if we even get one inch of snow all our schools close, but in Chicago one inch of snow is like rain drops. Go figure, it’s all good, let’s see how it goes.

Yes I know, I haven’t blogged in a while. There is so much to do and I didn’t have time to blog. I’ve talked to some people regarding the rides for this weekend for the new students. I know many of the new students are coming in this weekend from US/Canada. If you are a new student and if you haven’t done so, contact someone to give you a ride from the airport to wherever you’re staying.

This will be my first short break. The vacation is about 1.5 weeks, so that’s enough time to study a subject for the USMLE, if I don’t get distracted with the beach.

Today, I have spoken to a representative from the Accreditation Council for Graduate Medical Education (ACGME) regarding green book hospital rotations. To my surprise the lady didn’t know what I was talking about. She just looked up residency programs for internal medicine but she had no idea about green book approved hospitals for rotations. I looked online and I can’t find any list regarding green book approved hospitals. If any of you readers have any idea regarding this matter please let me know because I have no clue.

Accreditation Council for Graduate Medical Education (ACGME)
Main Office:
Suite 2000
515 North State Street
Chicago, IL 60654
Telephone: 312-755-5000