Written by: Sean Lazaro McMaster Medical School c2023, Hamilton Campus Where was your placement and what specialty was it in?
I did a clerkship elective as a cc2 in Adult Rheumatology at Brampton (BramEast Rheumatology Clinic.) How did you get to your placement? I drove from my house in Mississauga. The preceptor advised me on how to find free parking, but on the first day I parked in the parking lot in front of the building and paid. I didn't get funding from the school because my house was too close. Describe a typical day at your elective. The schedule was Monday-Thursday, 8:45 am - 4 pm. On a typical day, I would see 3-4 consults and 1-2 follow-ups independently. For each encounter, the preceptor would often give me a summary of the patient's reason for referral or history at the clinic. Sometimes, I would have to read the charts to find out myself. I would see the patient independently to get a history and perform a physical exam, then report my findings to the preceptor including my impression and plan. After this, I would return with my preceptor so I can observe how he communicates his impression and plan to the patient. Besides that, I had the opportunity to perform 1-2 knee and shoulder corticosteroid injections per day. On most days, the preceptor would also set aside 15-30 minutes to give teaching on various topics such as treatments for rheumatoid arthritis. What are some common conditions you saw? And do you have any resource suggestions? * The common conditions I saw or discussed include osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and gout. It would be helpful to quickly review the clinical features of these conditions to help with history-taking, as well as general concepts of diagnosis and treatment if you want to take a stab at proposing impressions and plans. A good Canadian resource is https://rheuminfo.com. What is your most memorable experience from this elective? The preceptor challenges his students to prepare a short 5-minute presentation on a topic of our interest at the level of first-year resident teaching a clerk, in order to give us an opportunity to practice teaching. I skimmed an article on the neurologic manifestations of rheumatologic disease because I'm interested in neurology and presented some of the things I learned there. I thought it was a great opportunity to practice teaching and receive feedback from the preceptor. Another great experience was the teaching session that the preceptor gave on how to start a practice for an outpatient clinic. This included considerations such as finding real estate/property for your clinic, hiring admin staff, where to find patients, etc. Even though I'm still a clerk, it was a very interesting topic to discuss. What was one thing you didn’t like? Honestly, nothing. It was great. Would you recommend this elective to current students? Absolutely. I learned a lot about rheumatology and it was a very comfortable/chill experience overall.
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Professors Lake, image credit: AngelaCan, TripAdvisor
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