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Hangcheng Fu – Fudan Univerisity Shanghai Medical College (China)

MEDI 465 – Acting Internship in Ward Medicine

As an international student who wants to match for residency in U.S and must complete many away rotations, I would say UNC MEDI 465 is one of the best rotation I have experienced among my away rotations. I learned of this program by recommendation from senior students from my university. And when I first looked it up, there were many details about the rotation posted on the UNC official website such as number of visiting students in different months and survey data about student life expense. Also, lots of questions I had were already well-addressed on the official website. From these details, I feel that this visiting student program is great and student centered. Most importantly, our program coordinator Camila is very responsive and enthusiastic. If we have any questions, we can directly ask her and she will always do her best to help us. The well-organized visiting program make sure that we as medical students are able to focus on enhancing our medical knowledge and improving the rotation experience because we don’t need to worry about other things.

As far as the rotation, it’s a thorough and integrated education about how to be an intern in the next year and I would say the best part of this rotation is getting “an original taste” of life in intern year in a protected environment. I remember I asked chief resident (Nick), my senior resident (Delfin) and my attending (Dr. Moore) separately the same question the first day: what’s your expectation of me? And their answers were totally the same: You will do whatever an intern does and trying to be a competent intern is our expectation. It set a really high standard for me, but they also did whatever they could to help me with the first couple days. And at the end of the first week, I was able to organize my own rounding schedule, knew the appropriate time to call consult, prepared discharge summary and even started to admit new patient from ED (including saving admission order).

Team pic of Med U

Besides the complete autonomy of the rotation, I was also impressed by two educational concepts at UNC. The first one is bedside rounding. Both Dr. Moore and Dr. Hauck emphasized on bedside rounding a lot so I reported the SOAP in front of most of my patients every day. I also found out that doing bedside rounding enhanced my communication skills with patients by trying to explain all the medical concepts to them in an easy-understanding way. It’s also beneficial for patient care because everyone is on the same page in this rounding format. The second concept is the continuous feedback. Dr. Moore gave me feedback directly at the end of first week and pointed out that I should try to admit new patients and think over how to evaluate and manage a totally new patient. When I tried to save admission order and write my admission note, I found out that even with a classic GI bleeding case, I would still miss subtle things. By being directly corrected by my senior (Torie), I had a very deep impression about managing GI bleeding in the future. Also, I helped one of our patients to obtain her pathology report from NIH so she did not have to do another bone marrow biopsy and probably start chemotherapy one week prior to the previous schedule. I remember Torie sent me a message to encourage me about that. It’s very motivated at that time for me.

Morning report

Also, I would say the internal medicine morning report is a “have to go” event. Every day I saw interesting case during morning report and it was also an interactive learning process. Whenever the presenter started case discussion, all of us would be actively involved in it and raise our thoughts. Sometimes Dr. Greganti or Dr. Bynum would ask= some seemingly irrelevant question on physical exam or history of present illness, but it turns out to be a great education point once clarified by David or Nick. Strongly recommended!!

Giant spleen lesion (cyst or hemorrhage?)

Lastly, one of the best moments I had at UNC happened when we discussed a super complicated case transfer from an outside hospital. The patient came with GI bleeding with amputated right foot and osteomyelitis left foot in the setting of diabetes, found to have multiple myeloma and a new onset giant spleen cyst-like lesion (Besides he probably still had 4-5 active problems). We all tried to figure out what’s going on with the patient. We spent 2-3 hours in the workroom in organizing our thought and proposing hypothesis. My senior resident Amy even searched related literature until midnight that evening and sent those to us the next day. I will say that was one of the highlight of my medical education experience: everyone was fascinated by the same medical puzzle!