Weeks 5-6

These last few weeks flew by, and at this point I cant belive my internship is coming to an end. Something that was interesting about week’s 5-6 is some of the patients who Dr. Stern had seen in previous weeks came back for follow ups, and I got to see familiar faces and medical problems. One of the days in this week Dr. Stern took me over to the hospital and I was able to obvserve the cath lab for a few hours. I actually got to see three stents be blaced is someones left main, which was a crazy procedure. 

The last week was extremely bitter sweet. I spent it all with Dr. Stern and had a pretty calm last couple of days. This was truly an experience I will never forget, and the types of things I learned I truly could not have anywhere else. 

Week 4

This week was jam packed with observing other doctors in the practice. I started on Monday getting a feel for the internist’s job in the practice. I was able to ask a lot about an extremely broad specialty, and get clarification about what it exactly entails. It was interesting to see the differences and similarities of a general cardiology and internal medicine check up. 

Tuesday I got the chance to spend some time with the ENT doctor, which was possibly the most interesting part of my internship. I had a lot in common with him in terms of our thinking styles and opinions about medicine. When I asked why he chose the specialty he told me it was because the neck really intrigued him. It is such a small p art of the body, yet all of the systems (except reproductive) run through it some how, which means there is a lot of emphasis on keeping everything in tact. Not only did I learn about the ENT specialty, but also got a lot of advice about applying for medical school and getting into research opportunities in the future. 

Wednesday I spent a few hours with the Rheumatologist, which was interesting because I had no idea what the specialty was before that day. I only got to see two patients with her, but got a lot of insight about quality of life care, and how important it is. 

Thursday I was back with Dr. Stern, but got a LOT out of this day. Almost every patient we saw had some variation of a heart murmur, which is interesting because I had one as a child. Learning exactly what a murmur is, and also the different types of murmurs is a large part of cardiology, as well as something I’ve been intregued about since I was younger. Actually getting to listen to the heart of someone with a murmur was really cool as well because one can actually hear a swooshing sound inbetween the beats, which are in tune with the patients pulse. 

Week 3

In terms of my shadowing Dr. Stern, the week was fairly similar to the two preceding it, and I now felt more in my element than ever. I finally got used to the morning commute, and general routine of my Senior Work. However, this was the first week that I was able to observe two different specialities other than that of Cardiology. This experience made me realize just how educational this process would be, and how I will eventually use it to choose a specialty in the future. 

On Wednesday morning, I got to the office and was brought straight into a procedural room to observe a colonoscopy with MHMG’s Gastroenterologist. The procedure was very interesting, and I learned a lot about why colonoscopies are necessary as we age, as well as a lot about the actual procedures and the different types of colon cancers. The experience also helped me realize that although it is a fascinating field, I don't think I will want to specialize in Gastroenterology, as it is not where my interests lie. 

On Friday morning, I was able to observe a typical OBGYN visit, where they were taking cervical biopsies of a patient. These are often used when screening for cancers and certain STDS. I was surprised that the patient consented to letting me observe the visit, but it was very informational. 

Overal, reflecting on week three of my internship, I have already been exposed to three specialties and have been able to get a sense for the vast amount of variation within the medical field. I look forward to shadowing other specialties!

Books

How Doctors Think By Jerome Groopman 

Once I picked up this book I was unable to put it down for the next week, eager to scan each page completely. How Doctors Think is an amazing book that gives great insight into what thinking process’s different doctors have to go through based on different specialties. The book recounts numerous real life cases as learning experiences for readers, with examples of where doctors went wrong, and where they were able to think successfully. It also discusses the downside of the modern medical industry in terms of technology. It is interesting how difficult it is for doctors to maintain the same patient relationships when so much of a visit now a days has to be devoted to logging everything in a computer for insurance purposes. I learned a lot from this book about what future specialties I might want to pursue because of how analytically my brain works, and which specialty might best match that. 

Iserson’s Getting into a Residency by Kenneth V. Iserson, M.D.

This book is AMAZING. I am so happy I came across it when looking for good literature relating to medicine. Although I might be a bit ahead of myself reading something about getting a residency so far in advance, this book touches upon what exactly medical students need to be successful in both choosing a specialty and getting a residency. It discusses all of the specialties in depth, with pros, cons, work hours, etc, and allows readers to follow a path to guide them into eventually choosing a specialty. Reading this book exposed me to many specialties that I didn't even know existed, as well as what I should be doing as a pre-med/medical student to get ahead in what I want to pursue. 

Take Aways from 21st Century Learning with John

Although this session was very short, I was still able to take away a lot of applicable information about critical thinking in the work place. Especially in medicine being able to think crucially, and apply a vast array of knowledge in a professional setting is key to being successful.

A Typical Day

A typical day involves me getting into the office at 11am. Since Dr Stern’s office isn't exactly situated for two people, I pull a chair around to her desk so that I can observe her taking notes. From there we start seeing patients (one every 30 minutes), with no breaks until 5pm. When I am in the consults with Dr. Stern, she asks baseline questions like if the patient has any pressure in the chest, shortness of breath etc, and then does a physical evaluation. She starts by taking the patients blood pressure, after, I listen to the heart with her, and form there she is usually able to make some sort of diagnoses. 

Describe your relationship with your site supervisor and colleagues

Since I’ve gotten the chance to spend SO much time with Dr. Stern over the past 6 weeks we have gotten to have a really great mentor/mentee relationship. Although most of our conversations are based around medicine, it has gotten easier and easier to generally talk with each other throughout the weeks. In terms of colleagues, everyone in the group is extremely friendly. One of the doctors actually pulled me aside during my time there just to get to know me and give me her card in case I had any future questions. 

What did you do? (concrete/daily tasks)

Since my internship is more shadow-based than intern-based, I don’t have a specific job within the group other than to learn. I have been able to closely shadow Dr. Stern, one of the cardiologists in the practice, but there is little I can do in terms of small jobs and tasks.

History, Mission and Structure of MHMG

Murray Hill Medical Group, the private practice has been around for 25 years and is affiliated with NYU Medical. Their mission is to provide the best quality care for their patients in addition to high levels of patient compassion. MHMG has two locations both in Manhattan. The first is 317 East 34th st, which is home to the Internal Medicine, Dermatology, Endocrinology, Gynecology, Ophthalmology, Otolaryngology, Physiatry/Sports Medicine/Pain Management, and Podiatry specialists. While their location on 347 East 37th st holds the Gastroenterology and Cardiology practices.

Job Description: Shadowing Dr. Stern at MHMG, seeing patients, possibly helping with paperwork, sitting in on procedures etc. I will also have the opportunity to shadow other doctors in the group depending on my interests. 

Week 2

Unfortunately this week was cut extremely short due to scheduling conflicts with my supervisor and I, and I only worked Monday. 

Despite the short work week, I still succeeded in learning a TON about atrial fibrillation (otherwise known as AFib). AFib is commonly known as an irregular heartbeat, but more commonly happens when a patients heartbeat rapidly changes, which can be dangerous for some. Almost every patient we saw on Monday had some variation of AFib, and it was interesting to see how the different types can affect patients. 

We saw some people who were constantly coming in and out of AFib with absolutely no symptoms, which means they could be sent along with little to no worry. We saw some who were constantly coming in and out of AFib who described a feeling of missed or skip heartbeats who needed to be put on medications to steady it. Lastly, we saw patients who had experienced shortness of breath, palpitations, and syncope because of their Afib, some of which will eventually need a pace maker if the medications don't help.

Dr. Stern also spoke with me on Monday about meeting with a few other doctors in the practice to get a feel for different specialties, which I am ecstatic about!!

Week One

Before I even started day one of my internship, I immediately knew it would be an experience unlike any I’ve had before. I didn't have to be in the office until 11, and commuted on the Lexington avenue subway line for the first time. Naturally, I left my house with over an hour to get there, in fear of possible train delays. This caused me to end up on the block of my internship at 10:30, anxious as ever, and dreading walking in a half-hour early. I quickly rerouted myself to a Starbucks, and while I was waiting in line for my coffee, I noticed I was not standing amongst other high school students, as I was used to, but a slew of businessmen and women all in a rush to get to their offices. This is when it really sunk in to me that for the next six weeks I would truly become a part of the working world. 

With coffee in hand, I walked back to the building of my internship, and after struggling to find the entrance for approximately five minutes, I took the elevator up to the seventh floor with my heart in my throat. I met Dr. Stern in her office, and there was little pause before she logged into her computer and started her day. I still had no idea of what I would be doing, or the types of confidentiality restrictions of private practice. She brought me into one of the administrators offices where I took a 15 minute course on patient confidentiality and got an official name tag for Murray Hill Medical Group. It was about five minutes after this that I was handed a stethoscope and went in to see my first patient alongside Dr. Stern. 

I was shocked that I was able to go in to see the patients, and that they seemed to have no problem with it. After two or three I started getting summoned over to listen to their hearts, and in-between visits had in-depth conversations with Dr. Stern about medicine, medical school, private, practice, cardiology, and basically anything you could think of. By the end of my first day of internships I was both exhausted and coming away with an immense amount of knowledge that would not have been accessible to me in any other setting. 

The rest of the week was filled with adjustments. I was given a white coat to wear, which was extremely emotional for me, and learned how to commute to her different offices. Solely through spending time with Dr. Stern I gained so much insight about medicine, and realized that this Senior Work would also be, in a sense, a language immersion program. The medical vocabulary is so vast and intense that it is impossible to stop and explain every piece of it to an eager high school student. So throughout my internship (with the help of google), I was also able to vastly expand both my knowledge and vocabulary. 

How Did I Find My Internship/The Process

From the beginning I knew I wanted to work in the medical field, particular in pediatric cardiology. Since my interests were so specific at the beginning, I was able to delve into the networking aspect earlier than most of my peers. Lavern was able to give me names and insight to many possible pediatricians and cardiologists, and I used previous contacts as networking opportunities. Although some of my efforts lead to dead ends, I soon realized that many students in my graduating class had parents who worked in the medical field, so I began to ask around. Shortly after I was given two leads on internships and one of those leads ended up being my internship. 

The application process was pretty simple for me, it consisted of a 10-15 minute phone call, with a followup a few days before my start. We talked a little bit about why I was interested in medicine, and if I would be okay with more of a shadowing structure. I then followed up a few days before the start of senior work to confirm her address and my working times for the upcoming weeks.

Internship Goals

• Gain insight into the medical field and medical school

• Learn more about what medical school is like and how to choose a specialty

• To come away with my internship with a better understanding of private practice, more specifically Cardiology

• Make life long networking connections within the medical field