Hi guys! I’m Dr. Priya Jayan. I’m an internal medicine attending. I’m a hospitalist here in the Bay area. So it’s 7:00 a.m. and I’m driving to the hospital
for my rounding shift. Rounding shifts start from 7:00 a.m. to 7:00 p.m. And this is basically, seeing patients
who have been admitted either overnight or yesterday or who’ve been in the hospital for a few days. An admittance shift is primarily just us
admitting patients from the ED. So here we go! So I just arrived and now what I’ll be
doing is printing out my list for the day and pre-rounding on all my patients. So on average, I have about 14
to 16 patients that I round on. And in the pre-rounding process,
I basically look at their vital signs, their lab abnormalities, anything overnight. Basically, improvement in the things
that we were treating them for. And if there’s any sort of specialist
that I need to get involved, I usually like to call them in the morning,
so they have a good heads up and they can come and see them in the morning,
just to get the ball rolling. After about an hour, hour and a half of rounding, I will go upstairs to do a interdisciplinary round
with the social worker, the case manager, the nurse
and the charge nurse and the pharmacist. So it’s about 12:30 right now and I’m
taking a little break to have some lunch. This is definitely different from residency life, where you literally had five minutes in front of a computer to scarf down your food. So now I get to enjoy being outside in our cafeteria
and take a little bit of a break and sunshine and I’ll get back to rounding again. I just finished doing the interdisciplinary rounds. And then I rounded with each of the patient, did a thorough physical examination, spoke with the family, spoke with the patient
about the diagnosis and the treatment. I also touched base with all the consultants. And then I’ll be right now, pretty much writing my
notes and following up on the labs and the treatment plans that we had
and how the patient is recovering. The range of diseases that we see
is quite varied in internal medicine, which is why I love it. We saw– I have a patient who has CHF exacerbation,
so we’re diuresing them with IV lasix. I had a COPD exacerbation, secondary to the flu. I also had a patient with AFib with RVR,
so I consulted cardiology and we have them on amiodarone drip. And a stroke patient
for which neurology is following as well. And then a DKA patient as well. We’ll just be following up to see how
they’re doing today. Following up their results and writing my notes. Hey guys! So it’s about 7:30 now. I just finished my rounding shift. It was a fairly busy day. I feel like during the winter months
people get a lot sicker and so the hospital is a lot more full. So internal medicine and primarily hospitalist, because one, I like the acuity of diseases
that we see in the hospital setting. And two, because of the pathology of the wide variety
of things that we get to see also. I also like more of that collaborative teamwork
with the other specialist. And I get to learn from them as well
as I’m kind of expanding my own practice. And while I’m not necessarily a specialist
in one field, I get to learn a little bit about every field
and kind of expand my knowledge of that. I still use UpToDate and I still use
a lot of my medicine books to go back to my pathology and my basics. So as a hospitalist and an attending,
I think what was different from what I expected was not so much the disease and the pathology, I think medicine and residency trains
you well for that. But more of that social aspect of things. My day really consists of a lot of phone calls from nursing, from case manager, from
social worker, from patient family and in planning of their disposition. So basically, where are they going to go
after being treated. So you know, treating patients is one thing but then
it’s figuring out, where can they go after the hospital. Whether it’s a skilled nursing facility
because they need more physical therapy. Or they need, you know, other additional help
or whether it’s in a Board & Care. Or whether it’s going home,
and do they have 24-hour care at home. How does it work with, in terms of their insurance? So a lot of that aspect you don’t realize
that you’re gonna have to deal with, when you’re in pre-med or in medical school. But that’s definitely a big portion of it. The path that I took, I was in UCLA undergrad. I did neuroscience, that’s my major. And afterwards, I applied to a lot of
US med schools and I didn’t get in. So then I decided to go to the Caribbean
AUC Medical School in St. Maarten and while initially I was a little bit nervous
what that would be like in terms of my career moving forward and what specialties I would be
able to get into, I absolutely loved my decision. I loved the medical school. I think, you know, the medicine that we learned
was in par with anything that we would learn here. It made me work harder
because I felt like I had to prove myself. In terms of finding a residency,
I was looking for one in California. And there are a few spots
that definitely accept Caribbean graduates. And so that’s gotten a lot easier because I think
a lot of people go to the Caribbean now. So it’s well known and the residency that I trained in,
in Santa Barbara was wonderful. I think I got some of the best attendings
and education and experience. And now I’m an attending
in San Francisco as a hospitalist. So for me it was a great decision. I wouldn’t take that back at all. So you know medicine, while it is a very,
you have to be very hardworking and dedicated and passionate about what you do, it also does take a lot of sacrifice. And I think that in order to prevent yourself
from being burnt out in medicine, it’s important to create that
balance in your life. With family life, with your own
diet and exercise. Being mindful, yoga meditation,
all of those things can help you. And ultimately, help you to better
take care of patients. So I think that’s key.