One of the more inscrutable whims of whoever it is that determines the requirements for internal medicine residency this year has been to require a "subspecialty month" in which we see a week of clinic in ENT, Ortho, Ophtho, and Psych. This week has been ENT clinic for me, and it's beeen a leap back in time.
What I mean is, I am basically functioning as a fourth year medical student. I don't know any of the surgery, so I can't really contribute there, and my idea of a clinic visit is at least 30 minutes long, so I'm not fast enough for surgery. These guys have are double and triple booked in twenty minute time slots, and they are rarely behind. On the plus side, I've seen a lot of scopes and procedures that I probably won't ever again, unless I go into general internal medicine, get really fancy in my own practice, and decide a nasopharyngeal scope is a worthwhile investment.
I've survived though and today was actually fun, even for an internist. Just when I was about to slide into the quick, only-the-highlights ENT exam on a patient, I figured out she had something more serious than just hoarseness wrong with her, and we ended up needing a fairly involved thyroid workup. That's something I know how to do. And then one of the later patients needed to be scheduled for surgery, and the ENT doc I was working with wanted to do it tomorrow. He looked at me and said "with this guy's cardiac history, anesthesia is never going to take my word on a physical so seriously that they'll approve surgery on this short notice. Can you do the H&P and write 'internal medicine resident' next to your name? They'll take that, I'm sure." So I did, and I don't think the surgeons minded my 25 minute exam, because it meant one more case on the schedule for tomorrow. It was nice to be recognized for expertise in my field, even if it is considerably premature.