Residency week 2

I just finished my second week of residency, and this week was mostly clinic. It was considerably more difficult than I thought it would be, because I didn't realize how much research a doctor actually has to do every time they encounter a new patient in clinic.

Whenever we have a new patient in clinic on our list, which right now would mean any patient at all since we are new to the practice, we have to go onto our online database and dig up every test, every hospital visit, every medication change, every single shred of information in this patient's medical history that we can find. That way, when the patient actually arrives in our exam room, there should be no surprises, or minimal surprises anyway. These patient lookups take me quite a bit of time the night before, and some days end late since there are a variety of things to do in the evening. Sometimes there is short call at the hospital and sometimes there is duty at the free clinic, so the scenario arose where I came home around 8 45 pm and had to chart-review 3 patients for the next day.

I haven't been keeping up with any of my actual medical reading because there's been all this clinic research and scattered other things to do, so the plan for next week is to do all the research today (based on however many patients are already posted on my list) and then, during the week, have time to review medical knowledge as the need presents itself. An additional problem is that I am not getting everything done despite having only one patient to see each hour, so I'm trying to work out a better system for that. So far, the best I have managed to come up with is

1) Start the skeleton while the patient is being roomed and then
2) Walk in and start blasting out an HPI and PMH while simultaneously talking to the patient, and then obviously review all the meds and problems with the patient, then
3) Do as much of the note as possible based on a skeleton so I don't have to type anything fresh out.
4) After 30 minutes (really hoping the first three things get done within 30 minutes) precept to the attending and tell them only the History of Present Illness and Past Medical History relevant to the problems that have to be dealt with by us, at this visit
5) Furiously copy down the plan in its entirety and make to-do check boxes for all the orders to be placed 6) Place all the orders quickly while the attending is talking to the patient.

I went out yesterday and, despite the usual shoddiness where eligible females are concerned, managed to land the number of a human resources manager, who thankfully was only 1 drink deep at the time. I don't know if we'll actually end up going out, but for some reason my friends were very impressed, borderlining on shocked. We'll see if anything happens with that, will update either way.