What is your experience as a medical extern?

I embarked on my journey to the US as a medical extern right after I finished my internship in Taiwan. During my three-month trip, I rotated to three different units. Each rotation is summarized in one of the following paragraphs. Overall, these experiences are the best time of my life.

Highlight (2022/08/01-2022/08/26): As a medical extern, I worked directly with Dr. Nanna to provide patient care. Specifically, I reviewed a patient's past history, medication, and lab results before the patient came. Once the patient arrived, I walked into the examination room before Dr. Nanna to obtain the patient history, conduct a physical exam, take vital signs and obtain ECG. Before presenting the case, I formulated a problem list with my own assessment and plan. I brought to Dr. Nanna's attention medications that a patient should have taken, which were crucial for the patient's prognosis. Whenever available, I assisted in cardiac ultrasound and exercise stress tests. I find this work experience rewarding in that my getting to the bottom of patients' medications could save their lives. I also realized that, even without specialized knowledge in cardiology, I was still able to take care of cardiology patients through effective communication.

Highlight (2022/09/06-2022/09/30): As a medical extern, I worked directly with Dr. Saint-Jacques to provide patient care. I saw 5 to 10 cardiology patients each day. Apart from office routines, I also emphasized optimizing patient care with clinical guidelines. I discussed my understanding of current guidelines with Dr. Saint-Jacques and assessed the likely benefits and harms of each treatment option, from medications to cardiac catheterization. In addition, I assisted in cardiac ultrasound and pharmacological or exercise stress tests by giving patients clear instructions throughout the entire study. After the study, I discussed the findings with Dr. Saint-Jacques and compiled the results into a final report. Moreover, I got the chance to handle billing and deal with situations when insurance did not cover a diagnostic test. Overall, this experience allowed me to practice medicine based on guidelines with more confidence. I also learned how to communicate with patients and prepare them for a diagnostic test.

Highlight (2022/10/03-2022/10/28): As a medical extern, I worked directly with Dr. Fagelman to provide patient care at a primary care office. Each day, I encountered 10 to 15 patients presenting with all sorts of needs, from establishing care to illness. I participated in direct patient care, including taking a patient history and conducting a physical exam. After obtaining relevant information from both the patient and the medical record, I presented the case to Dr. Fagelman and finished up the encounter with counseling on vaccines (e.g. flu, COVID, TDaP, etc), preventive screening tests (e.g. mammogram, colonoscopy, etc), and smoking/drinking habits. I also made sure that the patient got their referrals before leaving the office. I summarized the encounter in a clinical note and reviewed the chart the next morning with Dr. Fagelman. The experience taught me the holistic care, from primary to secondary prevention, that a primary care physician can provide.