Hate long rounds, suck at presenting, hate writing long notes

[Thruster]

Currently a 3rd year interested in applying IM, but I hate long rounds, am not very good at presenting and absolutely hate writing long notes that no one reads.

Part of it I think is because I feel so incompetent when I'm put on the spot during presentations, that I lose focus very quickly leading to a non-cogent train of thought/presentation. I know that I am fairly intelligent but it seems as if I will never be able to manage the logistical aspects of IM or daunting amount of path-pathophys that needs to be familiarized.

I can manage the first few likely ddx's but am lost on thinking about some of the more obscure causes. Also, it takes me forever to write notes and I don't enjoy it in the least.

I really love cardiology, and some aspects of pulm/cc and even gen med. but I'm worried about making a huge mistake if I apply IM.

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[officedepot]

1. take notes on your patients and spend some time thinking about what you are going to say before rounds. If you have to start earlier then do it. It takes practice to get good.

2. From my experience in private hospitals, assuming you do IM hospital medicine of some sort... there is no presenting, you round on your own usually, most notes are computer notes (sooooo much better - copy/paste when needed), and you go at your own pace. Clinic can be as fast or slow as you want (though in PP you'll often overbook and go really fast, doing your notes as you talk to the patient on the computer). Others on this board should be able to speak to this more.

The closest you get to a presentation is that you will have to sign out patients on weekends and nights and maybe discuss patients in group meetings but you'll do that so much in residency it won't be an issue.

My advice, if you love IM do it. You'll get better at the acutal "working aspect of the field" as you gain experience.

 

[adagio]

I second Officedepot!!

It is completely normal to take extra time during your debut, but as the learning curve advances, you will find yourself more efficient and more confident.

Best of luck to you during your residency

 

[blahwhatever]

You're only a third year, you WILL improve and your 4th year presentations will be much smoother. The thing with presentations is, as a third year, no one seems to know what to focus on, so they just want to memorize and present every detail. After your step 2 studying, you will go back to rotations being much more confident about what to leave out and what to remember.

As a resident, you will get even better at presenting. You will be doing everything for the patient, and it will be a LOT easier to remember and present in an organized manner.

 

[Mattchiavelli]

It's not as easy when you have a patient with 47 chronic issues, but when you admit a person and are ordering the stuff for their workup it makes it easier to remember what to follow up on, what to be thinking about, your problem list, etc. It becomes a different thing when you start automatically knowing what to do with lab values, can interpret ABGs without thinking much, know how to work up new issues, etc. If you have to look all of that stuff up IM will bog you down in a major way. My 3rd year I could pre-round only on like 2 or 3 people in an hour, now I can see like 7 people and have the majority of my day's orders written and be calling some consults.

 

[Heisenberg23]

1. take notes on your patients and spend some time thinking about what you are going to say before rounds. If you have to start earlier then do it. It takes practice to get good.

2. From my experience in private hospitals, assuming you do IM hospital medicine of some sort... there is no presenting, you round on your own usually, most notes are computer notes (sooooo much better - copy/paste when needed), and you go at your own pace. Clinic can be as fast or slow as you want (though in PP you'll often overbook and go really fast, doing your notes as you talk to the patient on the computer). Others on this board should be able to speak to this more.

The closest you get to a presentation is that you will have to sign out patients on weekends and nights and maybe discuss patients in group meetings but you'll do that so much in residency it won't be an issue.

My advice, if you love IM do it. You'll get better at the acutal "working aspect of the field" as you gain experience.

I agree with what the coronary angio said

 

[TPBC]

At my core hospital, all residents are mandated to write paper notes (attendings can use pre-printed notes). In the left margin, you list the meds with the amounts each day (sometimes it is broken down in both home meds and hospital meds). As I'm walking from room to room, all I see up and down the corridors are residents writing notes! Seems like a huge waste of time and manpower. Yes, there is some benefit from writing notes from scratch but after a few, there are diminishing returns.
C'mon EMR!!