Focus on Internal Medicine Careers: Internal Medicine Resident.
Following is an interview with Doug Kanis, DO, a first-year medicine resident at the University of Iowa, Des Moines Internal Medicine Residency Program and an ACP Associate member. The interview was conducted by Michael Johansen, a third-year medical student at Des Moines University Osteopathic Medical Center and the Osteopathic Representative to the Council of Student Members.
IMpact: Why did you decide to go into internal medicine?
Dr. Kanis: When I started medical school, I knew I wanted to practice primary care medicine, but I thought I wanted to go into family practice. As I did my rotations, I realized that I really appreciated the patient population of internal medicine. With internal medicine, I can still get the variety of patients that attracted me to primary care. I also like the idea that it can be a springboard into many other subspecialties. That opportunity does not necessarily exist with the other primary care fields.
IMpact: Do you have any plans to pursue a subspecialty fellowship or will you practice general internal medicine?
Dr. Kanis: I am going to practice general internal medicine. Certain aspects of many specialties are appealing, but I enjoy the variety of general internal medicine too much to practice anything else.
IMpact: What advice would you give to students who are preparing for the residency application process?
Dr. Kanis: To be honest, I did not really know what I was doing when I started the application process. Looking back, I would say that it's important to choose a specialty that you like and get comfortable with that decision. You will find pros and cons in any field. To determine which specific programs are best for you, start out with broad ideas about what is important to you and narrow your decision by examining the finer points of each program. Probably most importantly, do not discount your gut feeling.
IMpact: What are the biggest differences between being a fourth-year medical student and a first-year resident?
Dr. Kanis: Responsibility and call. Being responsible for my own patients means that, compared to when I was a student, I feel worse when things go wrong and I feel better when things go well for a patient. In medical school, taking call was somewhat of a novel experience. It doesn't take long for that feeling to fade during residency.
IMpact: Do you ever wish you were a fourth-year medical student again?
Dr. Kanis: I have fond memories of my fourth year, because I used my vacation time to travel. The transition to residency was difficult at times. One day I was a medical student and before I knew it, I was a physician. The learning curve was pretty steep, and I'm not sure I'd want to go through that again.
IMpact: Do you find that the resident work hour restrictions are a burden or a benefit?
Dr. Kanis: There are days I wish I had more time for patients or to finish paperwork, but the benefits of the restrictions are noteworthy. Keep in mind that the limits were largely put in place for the sake of quality care and patient safety. Also, more sleep and more free time equate to better learning while at the hospital.
IMpact: Do you recommend that students who are interested in internal medicine fill their elective clerkship time with medicine-related rotations, or is it preferable to gain experience in fields outside of medicine before beginning residency?
Dr. Kanis: The bottom line is to do what interests you. If you know you want to practice internal medicine, you should do enough of it to build a nice foundation for residency. However, I do recommend spending at least some elective time in other fields. You'll have plenty of time to learn internal medicine during your residency.
IMpact: Do you have any "pearls" or "golden rules" that might help others survive the internship year?
Dr. Kanis: Be nice to nurses. Wear comfortable shoes. My grandfather and father, both physicians, always tell me, "Make sure you eat first."
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