A Week in the Life of an MS4

Hi! My name is Hanna and I am a fourth year medical student at Sidney Kimmel Medical College in Philadelphia. I recently finished my interviews for Psychiatry residency and am eagerly awaiting Match Day! This month, I am starting my emergency medicine rotation at Jefferson Hospital, an urban hospital in Philadelphia. Here is a typical week for me on my new rotation:
 

Monday


Today, I am starting a new rotation on Emergency Medicine (EM) at an urban academic hospital in Philadelphia. Luckily, the first day of rotations are usually lighter and start with orientation and getting to know the ins and outs of each service. After over a year of clinical work, starting new rotations isn’t as daunting anymore, but there are always important nuances to learn with different specialties. EM is all about approaching the “undifferentiated patient” or a patient that has not been diagnosed yet. It is up to the EM team to do a thorough exam, order the correct tests, and ultimately to make the right diagnosis.


Tuesday


Although today is my first official shift in the ED, I have seen patients here many times before as a consult from other services. Surgery students are always in the ED seeing traumas and bowel obstructions. Psychiatry is often also consulted a lot to manage patients undergoing withdrawal or who are actively psychotic. However, the work flow as an EM student is very different from when I was on consult teams! There are lots of patients with many different issues that cross all specialties and you have to stay sharp on all of your medicine.



Best reflex hammer ever. A must-have for a good neuro exam!

I think I’m going to need new clogs before residency…


Wednesday


On Wednesdays, medical students and residents attend didactics sessions or lectures about different emergency medicine topics from 8 am to noon. Some lightning related injuries came up in today’s talks and I learned a new word: keraunoparalysis, a transient paralysis that occurs in some patients after being struck by lightning! Here is a picture of the pattern that lightning makes as it travels through the skin:


 https://www.emra.org/emresident/article/when-lightning-strikes/


Thursday


Today is Valentines Day! I still like to have fun on my clinical rotations on holidays. I thought it would be fun to make some Valentines Day cookies to brighten my coworkers’ day in the ED. I think it got me some bonus points with my residents and attendings 😉 Also, I got to put stitches in a patient who sliced open his hand. Always keep some perma-hand silk around to practice surgical ties!




Friday


Jefferson hosts the annual JeffHope Ball every February for students. The ball raises money for student run clinics in Philadelphia and the patients that they serve. My fiancée, who recently finished internal medicine residency, was my date. We had a great time, but it makes it all the more real that I will be graduating in just a few months!



Saturday


This EM rotation allows us to pick our own shifts, so I purposely gave myself all weekends off 🙂 I love to spend my weekends going to the gym and spending time with my dogs, Kelvin and Celsius (I’m nerdy, I know). My fiancée and I love to take the dogs to the dog park. Our puppy, Celsius, even met his littermates, Milo and Millie! It is so cute to watch him play with his real brother and sister!




Sunday


I normally spend my Sundays preparing for the next week by meal prepping and doing laundry. I also have to start studying for the Emergency Medicine Shelf exam, which is an exam covering my clinical experience in EM. In medical school, the best way to study is by doing practice questions like those in the Kaplan Qbank. It is getting harder to have motivation to study as a fourth year, but I am enjoying emergency medicine and will need to do EM shifts as a psychiatry resident, so it is all still high yield for me!
And of course, we make another trip to the dog park.




 

Johanna is a soon-to-be graduating medical student at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia. She has matched into Psychiatry at her home institution. Johanna likes to spend her free time running, gardening, and being with her family, which includes her fiancée, who works as a hospitalist and adjunct professor at SKMC, and her two dogs, Kelvin and Celsius.