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Emma Kange: LewisGale Hospital Montgomery, Blacksburg

If you could write a “letter” to your second-year self about rotations, what would you say?

Hey you :)

I can imagine how you are feeling right now, a little tired and not sure whether all your studying is going as well as it could be, and probably a little frustrated. I know you have wondered whether all of this will be worth it, and I am here to say that every decision you have made up to this point has yielded results you would not even imagine. You have loved rotations you did not think would be enjoyable and have learned more than you could imagine in one day.

All of those little things you thought you didn’t know somehow found their way to the surface and you have been able to shine. Patients have laughed with you; they have also cried with you and in each of these moments you have remained true to your intention of walking with your heart on your sleeve and it has worked. Patients have trusted you and have reassured you that one day you will be a great doctor.

What stands out about your third-year rotations?
An experience that stood out to me was an encounter with a college student who was experiencing an acute psychotic episode. He was really having trouble with making a decision on whether or not to admit himself voluntarily but was not quite sick enough for us to admit involuntarily. This went on for a few days and when he finally felt strong, he decided to admit himself and while talking with the social worker I sat with him and brought him snacks. At the end of his visit with us, he thanked me for caring enough to sit with him and for our patience throughout the week.

That moment really reinforced something I already knew but often forget—the time and compassion we give to people is truly appreciated more than we know. No matter how hectic a schedule can be, that undivided attention and true quality time spent with our patients can help change their lives for the better—so with this in mind I will always try to make sure my patients are feeling seen and heard.

Did anything surprise you about your rotation experience?

I went into clinical rotations with the understanding that I would learn from each rotation, but that I would only truly enjoy the specialty I believed I would go into, and that was OBGYN.

My first rotation was Internal Medicine and I do not think I could have been more nervous, but within the first week I knew I had found my home. I would learn so much in just one day that at times it was overwhelming, but there was never a day where I did not enjoy every moment.

When the rotation finished, I was still certain I would want to do OBGYN, but to my surprise while I was catching babies, I still missed being on the medicine team. So, I quickly learned that it was okay to be flexible, and it is okay to change your mind. The most important piece of information I had learned within those first few months was that I need to remain true to myself and make peace with the fact that although my plans have changed, I am still on my way to being the physician I came here to be. I think the surprise in this discovery was finding interest in things I had once seen as an enormous challenge, and that those very things would help me find my future specialty!

What is a "typical" day like for you?

Most days start with me trying to get some studying done before I head over to the rotation site, so I am typically waking up at 6 a.m. to do questions. Once I make it to the clinic or hospital, I try to take a glance at the patients we will be seeing for the day to mentally prepare.

Most preceptors will have you go see the patient first, and then you will present the case to them before going to see the patient again with them, so once the first patient is ready I will go see them so I can prepare my presentation. This routine will continue for the remainder of the day. Between patients we will talk about some take-away points to consider which I really appreciate.

During lunch, if I have time I will do some questions, but most days I do find myself making time to talk with my mom or just listen to music to relax. At the end of the day, I really try to prioritize getting some sort of physical activity, whether it be yoga or a quick workout at home. For the rest of the night, I study as much as I can manage and then get some rest!

How has the rotation experience helped solidify for you what you want to practice?

Rotations have greatly helped me solidify what field of medicine I would like to go into. I previously wanted to be an OBGYN, but after my first rotation, which was internal medicine, I was a little less confident about this.

After my OBGYN rotation I found myself missing my time in the hospital, and after my psych rotation I knew two things: I did not want to catch babies, and I needed to find a way to make sure that as a hospitalist I would be able to fulfill the part of me that was drawn to caring for patients’ psychiatric issues.

So, after a few conversations I was informed that there were medicine/psychiatric residency programs and immediately I knew that was what I was looking for. Rotations have also helped me determine how I would like to practice and that is a reassuring feeling to know I am moving in the right direction towards being a good physician.

What do you want people to know about what rotations are, how they work and why they are important?

Rotations are where you learn how to be a doctor!

You mainly learn how to talk to patients and get all the information you need to make a clinical diagnosis, and then use that information to develop a treatment plan. It is a real hands-on experience and has helped reinforce all the information we learn in the first two years as well as teaching us how to apply that information.