During my M4 year, I had the opportunity to work as a sub-intern on a general medicine team. It was an amazing experience for me to utilize my medical knowledge from the first 3 years of medical school and act as an advocate for my patients. I had a patient who had a recent extensive course of hospitalization before our team admitted him. He was recently diagnosed with invasive high-grade papillary urothelial carcinoma of the ureter and underwent right nephrectomy right before being admitted to the hospital with a fever of unknown origin. He ended up being diagnosed with infective endocarditis and required a long course of IV antibiotics before he could go home.

Not only was his case a diagnostic challenge, he was also very tired of having to stay in the hospital, as he had been in and out of the hospital for the past 3 months and now had to stay in the hospital with his new diagnosis of infective endocarditis. This quickly became evident to our team as he started to decline lab draws and medications, and his wife and two daughters quickly became worried about his physical as well as emotional well-being. At first, I was not sure how to approach the situation, as I had not had much experience taking care of patients with depressive moods in the general medicine setting. However, after spending even a few minutes everyday to get to know my patient better, I began to understand that he was on board with the treatment plans in the hospital but just wanted to go home. One morning, he flatly told me that he’s leaving against medical advice because he is so uncomfortable in the hospital. I told him that he is free to leave if he wants to, but we would love to see him stay in the hospital because our team is working really hard to get him better and asked if it would be better if we moved lab draws to late morning instead of at 5-6 am. At the end of the conversation, he said he would give it another try, and he ended up staying in the hospital until the last day of my rotation. I was able to say good-bye to him and his daughters on my way out of the hospital and wish him the best of luck in the future.

This sub-internship experience was very significant for me as it confirmed by decision to pursue internal medicine residency. I truly loved working with my team and working with my patients. I felt that I was making a positive influence on my patients’ lives not just as a source of medical knowledge but also as an advocate for their well-being. I am very proud of my grade from my sub-internship and especially comments on my communication skills with my patients. After this rotation, I began to jot down quick reflections and thoughts on my clinical experiences after on my computer. When I look back at these reflections, I am reminded that I am so fortunate to be able to pursue a career that allows me to make positive impact on someone life everyday. My plan is to continue this habit of jotting down reflections as I develop as a physician. I believe that I will be more resilient during challenging times.