Two Down, One to go
Despite my original good intentions I have fallen into my usual negligent pattern of blog posting. In the meantime I have completed two of the three electives I am kicking off clerkship with.

The first was internal medicine in Kingston. For the first week I did emergency consults for the medical teams because my preceptor was away on vacation. You may ask why, for a two week elective, they would place me with a preceptor that was going to be away for a week. That would be a good question, for which I have no good answer. When she returned I was in "general medicine" clinic with my preceptor for the rest of the time. My preceptor is actually an endocrinologist so almost all of her patients have endocrinology issues. I am horrible at endocrinology; I am taking the experience as a learning opportunity that I would normally avoid at all costs. I also got practice at dictation. A skill that has already served me well and is something that I wouldn't have done unless forced.

All things considered, it wasn't the elective I was hoping for but it turned out to be good preparation for my next elective. I practiced a lot of skills: history, consult notes, orders, dictations, clinic notes, presentations.

My next elective was neurology in Toronto. I had a great experience doing my pre-clerkship elective in neurology in Calgary so I was really looking forward to it. I was apprehensive as well. Neurology became my first choice of specialty after the great experience I had in home town (and my psych experience was less than ideal, but we won't talk about that). Between desperately wanting to impress, I was also a little nervous that this elective live up to my expectations. I didn't want a really disappointing experience to cast me into a sea of self doubt and indecision.

I had a good time. It wasn't as much fun as my previous elective in neurology, mostly because I didn't get to see as many patients as I would like. This is a perennial problem in Toronto, which has a reputation for being overrun with trainees at all levels. Despite not being as hands-on as I would have liked, it was a good elective. I enjoyed clinic and inpatient, and I found all the cases really interesting.

Tomorrow I am off to Winnipeg for two weeks in emergency. I am also really looking forward to this elective. But I a have to opposite problem of my last elective. Emergency has been on my list of possible preferred specialties for awhile, but has dropped down to a distant third behind neurology and medicine. My goal is to learn lots, get a good reference letter and have some fun in emergency. But, if I have a really good time, I will be back to not knowing what I should really be putting my effort towards. I can't be really competitive for both neurology and emergency and I really have to make a final-like decision.

Ahh, the self absorbed second guessing and self doubt of a med student. Where would we be without it?