June 23 2003

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My Family Medicine rotation began its second week today. Last Monday my group of 13 M3s, fresh from taking the Step, met at the school for our orientation. We have each been assigned to a family medicine physician around the state. The department really wants each student to get out of town and get some rural practice experience, but because of my family situation, I was allowed to get a clinic just outside of Jackson in a bedroom community. Most people try to get a town where they have family or friends that they can stay with, but others will end up having to live in a hospital room for the four weeks they are with their preceptor. The entire rotation consists of 4 weeks with the doc, and 2 weeks at Baptist Hospital, a local medical center. Our grade from the course will come from 5 components, each worth 20%. These include a written exam based on material from an assigned text book (Essentials of Family Medicine), a clinical skills exam using actors feigning various illnesses, a written assignment that includes a comprehensive history and physical, the NBME shelf exam, and a score given by the preceptor. Besides getting this info, the rest of the orientation consisted of a demonstration of the latest insulin delivery devices by a pharmaceutical rep who supplied breakfast and lunch, getting parking permits for the Baptist, and once again practicing the pap smear and flexible sigmoidoscope procedures on the dummies. We did this in ICM last year, but they wanted to give us one more shot at it. We were also told that this would allow us to tell a real patient that we had done these procedures before without necessarily mentioning that our prior subject, Jenny, was made of latex.

I got up early on Tuesday morning and made the 20 minute trip to my doctor’s clinic. He works with one other physician in a branch of a local chain called MEA Medical Clinics. A lot of people at the University refer to them fondly (or snidely as the case may be) as “Doc-in-the-Boxes.” It was my first meeting with Dr. S and I was surprised to find him a lot younger than I anticipated. In fact he is three years my junior and is only 8 years removed from doing his own M3 family med rotation. The first day I pretty much just followed him around and observed his techniques, but by the second day I was going into patient rooms and getting the chief complaint and history of present illness (CC and HPI in clinic talk) myself while doing the pertinent parts of the physical exam. In 5 days now, I have seen well over 100 patients. Most of the stuff is pretty easy and routine – sinusitis, pharyngitis, UTI, etc. Back problems are extremely common too. I have witnessed a couple of pap smears, helped with an abcess drainage on a guy’s butt, given a steroid injection, and done a few strep cultures.

Dr. S admits to a local hospital and does rounds about 6:30 in the morning. I have met him there a couple of mornings to see patients and we grab a free breakfast in the very nicely stocked physicians lounge. Clinic runs from 8:00 to 5:30 or so depending on how difficult the last appointments are. The staff is really nice, and I have spent some time learning how the whole office operation works. Three out of the five days, the ubiquitous drug reps have bought our lunch and catered it in. This is extremely popular with the staff and me as well! I have a friend who told me way back at the start of the M1 year that she wanted me to let her know the first time somebody called me Dr. Lee. Well of course I get called that a lot by classmates in a kind of looking to the future way, but this rotation is bringing the first uses of that sobriquet from regular people. And the thing that made me feel the best was during one of these freebie lunches. Orders had been taken for our choice from a local deli, and when the lunches were brought to the office, my bag had scrawled across the top in black Sharpie, Dr. Lee. Now that is too cool!

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About Marcus Lee

Child Neurologist
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