Reflections from my first year of Internal Medicine Training!

In the spring of 2022, as we were nearing the end of specialty application season, I woke up on a faithful day and accepted my offer to train in Internal Medicine!

As widely known, amidst the myriad of decisions doctors make in their day-to-day life, probably one of the most nerve-wracking of them is the choice of a postgraduate specialty training programme. 

Medicine as a career offers a variety of options and opportunities for one to explore. While this looks promising, it can be very challenging to manoeuvre.

Of all the options available, I chose to proceed with Internal Medicine.

The UK Internal Medicine Training(IMT) is a three-year program geared at equipping trainees with the skills needed to manage a variety of general medical conditions. This training also serves to prepare trainees for the Medical Registrar role. You can find more details on this website.

Internal Medicine is one of the most unpopular specialties to embark upon in the UK due to obvious reasons: most notable is the weight of responsibility associated with the largely dreaded Medical Registrar role. 

Asides from this, one needs to put a lot of effort into acquiring sound clinical knowledge as a physician. In addition, the medical team in an average hospital deals with a large proportion of patients presenting to the emergency department. As you can tell already, this journey is definitely not for the feeble-minded. 

My dear readers, it’s been one solid year of training to become a Physician! 

How does this make me feel? 

The past year has no doubt been filled with its own ups and downs: ranging from the euphoria of being a new trainee in a new work environment, living in a new city, meeting new work colleagues (at least every six months) with the added icing of manoeuvring life as an immigrant doctor. 

My rotations in my first year were Older People’s medicine(Geriatrics/Care of the Elderly), Acute Medicine and Cardiology. Progress through the training is assessed by a panel of clinicians through a process called the Annual Review of Competency Progression (ARCP). 

My main activities in the first year were geared towards acquiring competencies needed for the ARCP, getting my exams done, attending a few courses and gathering the experience needed to make a good Medical Registrar while building my clinical decision-making muscle.

Here is a glimpse of each of my rotations below: 

GERIATRICS ROTATION

This was my first rotation and a remarkable one for me. Coming from Nigeria where Geriatric medicine is an evolving subspecialty, my Geriatrics job offered an eye-opener into the intricacies of caring for the elderly population. I journaled my end-of-rotation reflection here. 

I found myself appreciating the power of time as humans and the importance of using it wisely while we have it. Most of all, I enjoyed listening to the stories my delightful elderly patients had to tell during my ward rounds. 

Initially, Geriatrics felt slow-paced to me as I had been used to the hustle and bustle of other more fast-paced subspecialties. With time I settled in and had the most enjoyable time. 

ACUTE MEDICINE/CARDIOLOGY

For this block of rotations, I spent three months in the bustling Acute Medical Unit and another three months in Cardiology to wrap up the year.

Acute Medicine deals more with assessing and treating patients with urgent medical needs. It can be referred to as the ‘shop floor ‘ of Internal Medicine. I personally refer to the Acute Medical Unit as the ‘marketplace of medicine’ where you get to see a wide variety of medical conditions presenting mostly acutely.

As you can tell, it is more fast-paced. I was really looking forward to this rotation given the problem-solving opportunities it offers as this appeals to my personality. 

Due to its fast-paced nature, it was obviously challenging but offered a great learning experience. I got to have hands-on experience with some of the core IMT procedural skills.

Would I consider becoming an Acute Medic? Well, you have your answer- only the future can tell!

Cardiology for my non-medic readers is a branch of medicine that deals with disease conditions relating to the heart. It was my last rotation and I had an amazing experience in the unit getting myself involved with the care of patients with acute and chronic heart conditions. 

To conclude: 

You may already have deduced, the journey to becoming a Medical Registrar is not a walk in the park. It takes a lot of hard work, persistence, and perseverance to get through the process.

As I mentioned in this post, I would rather focus more on enjoying my journey, savouring every moment as they come, and taking the lessons from the downs while ensuring to celebrate every small win.

Of course, it was not an all-round smooth year as is life itself. There were a few glitches here and there. This was where my support system came through for me. I would encourage young doctors to ensure to have a strong support system, which could be in the form of family, friends, mentors, or assigned supervisors at work.

What next: 

We are off to IMT2 guys! Your ‘lovely trainee’ will be starting with Diabetes and Endocrinology. I think I’m going to love it there. Don’t worry, I’ll come back with another reflection. 

Thanks for reading to the end! You are the real MVP!

Let me know in the comments, which of my first-year specialties you think I should consider doing for my higher speciality training.

I’ll see you soon!

Love,

Dr Aarin