Family Medicine Residency Updates…

Hello my readers! (Grab yourselves a coffee/tea because this is a lengthy post.)

Happy Holidays! Hope you had a wonderful, safe and healthy time this Christmas break. Please stay indoors as much as you can and associate with your “circle”.

A Medical Monday post was overdue. I was to write one after my Psychiatry rotation but I did not because a few days into my Psych rotation I decided to take that Block off for personal reasons. There was some unexpected news within my family which I knew about while I was in Internal medicine (IM). I somehow managed to survive IM but I was emotionally and mentally burned out. My program was very understanding of the situation and I was able to take a block (month) off. I spent the rest of the time with my family, I definitely needed it.

So because I took the block off, I now finish Psychiatry in my second year. My schedule changed as follows: YEAR 1 (click on the links if you want to read up on my previous experiences):

• PRP 1 & PRP 2 -> Completed
• Bootcamp (1 month) -> Completed
• Family medicine (2 months ) -> Completed
• Internal medicine (1 month) -> Completed
• Psychiatry (1 month) BLOCK OFF
• Family medicine (2 months) -> Almost Complete
• Emergency medicine (1 month)
• Hospitalist medicine (1 month) Obstetrics & Gynecology
• Family medicine (2 months)
• Pediatrics (1 month)
• Elective (1 month) – another block of Internal Medicine

I am truly enjoying my two months of Family Medicine. It felt good coming back to familiar surroundings and working with preceptors that I know and enjoy working with. I felt there were a few changes in myself when I returned to FM (I have to thank grueling Internal Medicine for this):

• I feel better about my approach to challenging cases than when I first started out in FM
• I am able to recognize and prescribe medications with more confidence
• My patient conversations and notes are more “on point” with less unnecessary information
• I present my patients with more confidence and knowledge
• I recognize my limitations and voice it without fear of looking stupid
• (A patient who was disrespectful, yelling/screaming at me) I handled this experience calmly. I received great feedback from my preceptor about my professionalism and ability to handle difficult patients.
• I still need to work on: my time management skills both in clinic and at home, increasing my exposure to procedures, more studying on what I saw in clinic!

Also, in these past two months:

• My first presentation in residency: Nexplanon (subdermal contraceptive implant that is available in over 100 other countries but was only approved by Health Canada in May 2020! We are all getting trained to put them in! Hopefully we have some patients in 2021 want this! I am excited about this!)
• I had some amazing Horizontals/Specialized clinics: (virtual) Lactation Drop In, Diabetes clinic, Women’s Contraception, Smoking Cessation (in January)
• Finalizing my research topic -> Pregnancy during COVID-19 and the anxiety that pregnant women face during this pandemic. More details on this later!
• My plan is to do a PGY3 year in low risk obstetrics and women’s health. I have a meeting with my academic advisor in January to discuss what I need to have ready to apply for a PGY3 year. (My elective is in ObGyn).
• Long Term Care Home (LTC)
  • At the beginning of our residency we are given 7-9 names of seniors who live in the LTC home. In non-COVID times (previous years of residency), residents could walk into LTC and check up on their seniors and write orders etc. anytime they wanted. Now, because of COVID things have changed!
  • Once a week in the morning for a few hours, we meet as a group with our preceptors to discuss any concerns we have about our LTC seniors. We can read up on updates of our assigned people on the electronic medical record (EMR). We can speak with the nurses and we can speak with the substitute decision makers over phone, but we cannot walk into LTC unless it is our week to go in – very strange I know!
  • If we want anything done (orders, physical exam etc.) we have a confidential document where we write in requests for the “In-house resident” to complete.
  • In-house residents are residents who are scheduled a week to spend in LTC (we don’t have to go into regular clinic for this week). The week before we go into LTC, we have to get a COVID swab done and it must come back negative to start.
    • During our time as an In-House LTC resident our responsibilities are 1) to meet our assigned seniors 2) write notes on them/order labs/updates if needed 3) Work on the requests in the confidential document from other residents about their seniors 4) help the nurses should they request us for help with anything (the LTC Home has over 200 people residing there)
    • Last week, it was my first time at the LTC Home and it was surreal for me that these 9 seniors I have been reading up on via the EMR (since July!) are actually REAL people. SO strange I tell you!
    • The first day I was there, after my orientation I went to each one of my people’s rooms (or saw them in the hallway in their wheelchairs) and introduced myself and just spent my time speaking with them about….anything!
    • A few of them had dementia and were confused about who they were/who I was/where they were…that was their baseline. So I checked with the nurses to see if there were any changes in their health any concerns…
    • Others just wanted company and just wanted to talk. Some had family who visited, others did not have anyone visit them, also because of COVID there was a restriction to who and how many could visit.
    • Overall I really enjoyed the experience. Truth be told, I did not expect myself to like it so much! My heart went out to all of them, the seniors and the staff/nurses who worked incredibly hard. I hope that I am scheduled to go back to LTC in my upcoming FM blocks in 2021.

I’ll end the post now. I work over the Christmas break and I have New Years off. Then another 1.5 weeks in January before I move onto Emergency medicine and ObGyn! It’ll be a lot of hard work but looking forward to learning A LOT!

2020 has been a difficult year for all of us but look at how far we have come? Always feel free to leave me a comment/send me a message 🙂 Stay safe and healthy. Practice physical distancing and mask wearing. There will be a new post in the New Year!