Book to Bedside 2013

Over the past weekend I had the opportunity to visit the Michael G. DeGroote School of Medicine at McMaster University for their annual "Book to Bedside" Internal Medicine symposium. Organized by McMaster medical students in their final year, this event provided a great combination of information about choosing Internal Medicine as a career, information about McMaster’s Internal Medicine residency programs, and hands-on, interactive workshops geared towards students in their last two years of medical school. As a third year medical student at Schulich School of Medicine and Dentistry at Western University, this symposium gave me the opportunity to visit another campus, meet other medical students, and see what a different medical school offers to its students.

Our morning consisted of a series of lectures from Internal Medicine faculty members. Overall, these speakers were able to clarify some misconceptions about Internal Medicine as a career. A graduate of Internal Medicine is not "just an internist" who could not make up his or her mind about a specialty. In reality, a career in Internal Medicine allows for incredible flexibility, allowing the clinician to shift roles depending on current interest:  from the management of hypertension to peri-operative medicine, to medical management of pregnant women. Internists are also the physicians that other physicians in primary care or subspecialties may refer their patients to in order to clarify diagnosis. Not only will an internist be able to see a wide variety of patients and disease presentations, he or she also has the opportunity to work in a variety of settings. Internists may work in the community or in academic centres. They may work in hospitals but also have the option, with the current pressures to treat complex patients outside of hospitals, to work in new and modern Adult Ambulatory Care facilities. Furthermore, as physician unemployment or underemployment is an ongoing issue in Canada, medical students will also be happy to learn that the demand for internists remains robust.

Dr. Josh Wald, a third year resident in Internal Medicine at McMaster, also gave a great lecture about key impact trials in Internal Medicine. As a clinical clerk who has not yet completed her internal medicine rotation, this session was a great reminder to keep in mind not only facts but to also remember where the evidence from current medical practice comes from. Dr. Wald noted that all medical students should be aware of the following trials (with such clever titles) during their internal medicine rotation:

• The POISE Trial
• The TRICC Trial
• The PROGRESS Trial
• The ACCORD Trial
• The Rivers Trial

This session also reminded me that soon it will not be sufficient for me to only refer to textbooks and my lecture notes as evidence-based medicine grows and changes as new information becomes available.

The afternoon sessions were my favourite part of the day. Here, I was introduced to lumbar punctures and central line placement as was able to review how to interpret Chest X-Rays. McMaster has some wonderful resources for its students including simulators and models as well as its second year Internal Medicine residents who graciously gave up their Saturday to share their knowledge with us. Learning new skills in an artificial, low-risk environment has always been one of the most valuable parts of my pre-clerkship years. Such practice models are not always readily accessible to medical students. I was able to ask as many questions as I wanted without feeling silly and could troubleshoot any issues I had without feeling pressured. Simply having the opportunity to be introduced to what an “LP kit” looks like before I see one in the clinical setting helps to familiarize me with the situation and builds my confidence.

Overall, Book to Bedside 2013, in my opinion, was a success. It helped me understand what Internal Medicine is all about and also gave me some tips and pointers that I won’t forget before my internal medicine rotation next summer. Thank you very much to the students at McMaster for organizing this event and opening up your lovely campus and facilities to us. I would recommend this event in the future to students interested in Internal Medicine or who would simply like to learn more about what a career in Internal Medicine as well as McMaster has to offer. It was also a great opportunity to attend workshops and practice skills that will be important during clerkship and beyond.

Justine D., Class of 2015, Western University