Returning to the wards

From ScribbleWiki: MD PhD Advice

Returning to the wards is a stressful time, both because you've been doing something else (lab work, classes, etc) for several years, and because being on the hospital wards is unlike anything you've other done. It doesn't require you to be smart or know a whole lot; rather, it requires you to be prompt, have a saccharine disposition, be interested, hold your tongue, and occasionally look things up. All of which you know anyone can do. It also requires you to be open-minded, and learn, and be okay with being befuddled.

• Hire a therapist. If too expensive (or you're too manly), find some friends. It'll take some time before you don't bat an eye at dying or crying patients; until then, hold on...

• Consider some warm-up.

If you haven't had any clinical exposure during lab years, consider shadowing someone for a week or two before your first formal rotation. Dr. Barry Wu at St. Raphael's does a phenomenal job recoaching Md/PhD students. You may have to get lucky to match up with his attending schedule, but a 2 week experience should be enough. Email him directly to try to set this up (bwu at srhs dot org). Final medical student details are coordinated by Kathy Contois (kcontois at srhs dot org). Dr. Wu will treat this experience less like shadowing and more like a brief Med rotation with actual responsibilities on an actual team. If schedules don't work out with him, consider shadowing someone else in internal medicine. If you're not interested in any formal credit for this rotation, then you don't really need to coordinate this with the Yale Office of Education.

• Activate your beeper

Check your beeper ahead of time as they have a tendency to fail over the years. If replacing the battery doesn't revive your beeper, Yalies should contact Barbara Frank on the 3rd floor of ESH (737-4193). She will likely be able to provide you with a new pager with the same old number.

• Figure out your password to relevant hospital computer systems (By far the hardest part)

Yale has several suites, each with different administrators.
Outpatient: Centricity/Logician. Administered by the MIS Help Desk (688-HELP)
Inpatient: Sunrise/SCM (formerly CCSS). Administered at 300 George St. Refresher courses are held by Fran (688-3017) MWF at 8:30a and W at 1pm in classroom 2 on the first floor. You may need to be reactivated to be in the system, this is currently handled by Gisella Weissbach-licht (3rd floor ESH). She will need your full name, DOB, and last 4 of your SSN.
ED Records: In theory you can log into the ED system to print up H&P paper using your Sunrise id as both id and password. This does not always work for students.
OR logistics: Navicare. Should be available from any hospital computer. Login information currently uncertain.
Educational materials: Blackboard. Administered by the medical school library, in particular by Judy Spak. You may need to be reset in the system, and if you email her, she should be able to set your username and password to your netid. Terri Tolson can give you your Blackboard student ID should you end up needing it.
Evaluations: E*Value. You will likely be sent links to this after every rotation.

• Wash your white coat.

Hot water, bleach, and Shout stain remover can do wonders for yellowed collars and sleeves. May require multiple washes. If really stuck, try rubbing in some Cascade liquid dishwashing detergent (it contains bleach, so use gloves!)

• Do laundry - buy some clothes

• Find your stethoscope.

• Sleep in, but at some point before returning shift yourself to an early morning schedule!

• Don't overload your pockets with lots pocket manuals and cards. You can do very well with just a pocket pharmacopeia and the UpToDate available on every hospital computer. If compelled, buy a PDA and load it up with free Yale software (Mark dot Gentry at Yale dot edu).

• Take it one day at a time. Questions that it will seem obvious and rational for you to ask will be 'clinically irrelevant' or 'esoteric' to your residents and attendings. While you will likely know more basic science than anyone else on your team, remember that you are on the wards to learn clinical medicine.

• Fight the urge to correct the resident who has done some summer molecular biology research during college, and have somehow become a self-dubbed 'expert' in tyrosine kinase signaling. Importantly, these residents are often well-respected 'scholars' on their teams, and it is not your role to break that illusion.

• Instead, during such times of stress and fatigue, take advantage of the wards snack food. Honey graham crackers, peanut butter, grape jelly milk and mini-juices are ordered to every flooor, and are for all students and staff. They are sometimes hidden in the nursing conference room. The MICU, SICU and OR lounge usually has a larger variety, including pudding and ensure.