Season Two, Episode Fifteen: Intern in the City

The last few weeks have been kind of a blur. I remember taking my last Therapeutics final EVER. Then there was that 20 minute Health Economics final. Then I remember having my Therapeutics Oral Exam with Dr. Lee about a patient who has a cryptococcus infection. Then somehow, we were all done.

It was a bit anticlimactic. We had different scheduled times for the Oral Exams, and since the Oral Exams were our last final EVER, we all got done in different times. But for the most part, it was surreal. I've spent the last 8 quarters with my classmates, trudging through 8 am classes (some during our third year! How unfair is that!), frantically reviewing (or in some cases viewing) notes for an upcoming exam and having the time of our lives as we traverse through pharmacy school with a wonderful city like San Francisco as a backdrop (or in some cases, a critical co-star). And now the moment has finally come when we went our separate ways, albeit temporarily. For most of them, the next time we'll see each other will be during Graduation (in May 2011). I am one of the "lucky" ones to call San Francisco home for the next 9 months for rotations, but some of my dear friends have been assigned to the other satellite rotation sites for UCSF like Davis, Fresno (Fres-YES!), LA/OC, North Bay, and South Bay.

However, it felt good to be finally be done with didactic learning! Well technically for me, I still have a quarter left of classes (since I'm part of the Health Policy and Management pathway), so not really, but for the most part, we've all reached the point where we can apply all the theoretical knowledge that we've managed to soak up (or cram in some instance) and practice it in real-life patient interactions.

I'd be lying if I said that I wasn't nervous about this impending change. Rotations are a big deal. We're not playing with made-up patient cases anymore, so if I forget the dose on the test, in the grand scheme of things it's not that big of a deal, but now, we're dealing with actual people now, with presenting cases that are not as clear-cut or as neatly arranged for us. There's no "problem list" for us to look at and know what to deal with. For the most part though, I was very excited to start rotations. I'm the kind of person that learns a lot more effectively when I put concepts into practice.

So far, my life outside of pharmacy didactic learning is going well. For my first rotation block, I was assigned to Ambulatory Care for 6 weeks then followed by a week break, and then my General Medicine Acute Care block for 6 weeks. The last two six-week block will be my electives (Acute Care Pain Management at VA-SF, and Hospital Administration at SFGH).

After talking to a few of my classmates, I'm definitely glad that I started my rotations with Ambulatory Care. Coming into it, I've heard that it is a very doable rotation; not necessarily easy, but manageable. If this past week is a barometer, I'd say they were right on. I'm extremely happy so far with the clinics that I was assigned to. One of the things that I like about the Ambulatory Care set up is that I get to talk to patients one-on-one, and I get to manage their disease states or any acute disease they may be presenting with. Mostly though, I like the way the patients are receptive to our efforts, and that they are active participants in improving their health.

I'm partially dreading my upcoming block, because if it's anything like how my friends/classmates have described it, it'll be a seemingly impervious uphill climb a la 3^rd Avenue proportions. Heavy patient load (working up 18 patients a day is not unheard of), unreal expectations, copious amounts of stress and circling thoughts of imbecilities and uncertainties are all in a 12-hour-day's work (if not more). And you wake up early the next day for the next 5 days, and press repeat for the next 6 weeks.

But I feel as though this first six weeks will only help me prepare for the worst. I say this now, but we'll see if I'm still standing after this block.

PS: Last week's column was in fact an April Fools' Day edition of Single in the City. So, for the record, I'm still NOT engaged, and I didn't fly out to Milan. If only.