Interventional Radiology: The intersection

I spent a month on the interventional service in September; a month I had anticipated long before it arrived. Since the moment I set foot in the hospital, I had been enamored with the IR department; despite this, I had only been able to experience it in bits and pieces through the periphery of other services. My IR month was largely my favorite month on medical school – interventional radiology is a phenomenal field with everything that appeals to me – imaging, interpretation, procedures, teamwork, gadgets, and innovation. I would highly recommend at least getting some exposure during your clinical years because it’s such an integral part of US medicine.

Much like surgery, there is an immediate satisfaction in many of the interventions – passing a stricture, draining an abscess, stopping an internal bleed, or creating an exit for a backed up biliary system. In my personal experience, the residents and staff are much more personable and willing to teach. The attending physicians were receptive to students helping out and did some decent teaching. On the service, I was able to be first assist on some of the more involved procedures, including fistulograms, PTCAs, and some GU stuff as well. I did realize that I need to be far more familiar with the ultrasound probe and its orientation – the interventionalists are wizards with the thing.

Lastly, much has been said about the longitudinal follow-up of patients after IR intervention. This has, for better or for worse, spawned the new IR residency with minimum clinic time, etc. I don’t think I have enough experience to comment on this competently, though I can say as an applicant it is a headache and a half. All in all, I look forward to this service during residency, and potentially fellowship.

Emergency Medicine: In the heat of the moment

In August of 2016, I rotated through the emergency department at what I consider my home institution. I think a combination of factors played into my overall takeaway from the month – I enjoyed the whole clerkship immensely. I was fresh off of my Step 2 CS and CK exams, and therefore clinical workup and management was fresh in my mind. There was a large amount of autonomy given to students and residents by the physicians and staff, and, having rotated through a fair number of other services, my time in the ED felt like it was the last missing piece in the patient hospitalization process.

Easily the best part of the rotation was being able to see the patient firsthand and make clinical judgements and assessments without other physician input. The wide gamut of pathology and diverse population allowed for a very broad experience. There was also plenty of suturing to be done, and I was able to sew up three facial lacs, a hand, and two knees.

Overall, I found my EM month an imperative part of my education, and though I will not pursue emergency medicine professionally, I can better appreciate the lifestyle and pressures of such a career.