Ambulatory

I am now on Ambulatory Care. What is ambulatory care? This is basically treatment of ambulating patients = healthy patients. This is clinic setting medicine where the patients are generally healthy and coming in for follow up treatments of chronic disease states like diabetes, hypertension, etc. Also patients come in for physicals, general check ups, etc. 

Today was my first day of ambulatory and I really liked it. The doctor I am working with is an internist and is a great mentor type physician. He has been in solo practice for 20 + years and has a ton of experience. He is also an excellent teacher which makes for a good learning experience. He also sees a wide variety of patients. Today we saw a bunch of different pathology; penile cancer, diverticulitis, stomach tumor, lung cancer, debridement of an infected finger, stitches removal, hypertension follow up, diabetes management, arthritic knee injection are just a few of the cases I saw. None of the patients were in need of hospitalization but some of them may progress in their disease to the point needing hospitalization or even death.

I was able to see and manage many patients completely on my own. I just started seeing patients and working them up and making my recommendation. The doctor was impressed and said that he has never had medical students work independently in this manner. I did not really give him the opportunity to restrict my level of involvement because I arrived before him and just started seeing patients. Then when he arrived I presented the cases I had seen and told him my diagnoses and plan / treatment. He saw that I had made the correct diagnosis and treatment plan so he was confident in my abilities and let me continue on in this fashion the rest of the day. It was an excellent day.

Tomorrow I am scheduled to work with a different doctor in a different city. This doctor is a GI (gastrointestinal) specialist. I imagine most of the patients will suffer from GI disease like GERD, peptic ulcer disease, cancers of the stomach, small intestine, colon, etc. We will also do colonoscopies as well. This should be interesting and good experience. 

For the next 3 weeks I rotate between the internist and then the GI doctor and I should learn quite a bit. It is amazing to see how much I have learned this year. I was thinking back to my first rotations and how unsure I was and comparing it to now I feel fairly comfortable in most clinical scenarios. I still have a ton to learn but I think that will always be the case. I am sure next year at this time I will look back and again appreciate the growth and learning that has occurred.