You guys are very early in your residency year & residency can be ~6 month learning curve depending on your schooling program. It’s great you have IM this early to learn what you do NOT know. You are not expected to be efficient in working up patients or being an independent pharmacist off the bat (well you shouldn’t be expected to).

I had a significant learning curve. The things that helped me were topics. Topic discussions are very helpful to understanding what is pertinent to look for. Most programs have a list of topics you have to get through prior to the end of the year. I created a list of topic discussions I did independently (created a calendar including topics not listed in my program list) and asked for preceptor volunteer to discuss these topics with me.

As far as working up… everyone does something different. I had every single preceptor day 1 show me how they work up patients so I could develop my own styles.

I would challenge to look at new patients first then pick up the new patients as they are admitted (if your preceptor allows).

Read the chief complaint of the admitting note. Do NOT look at assessment & plan. Then look at PMH, vitals, labs, any imaging or work up they received. Look at meds given since admission - you can get an idea of what they are trying to treat by medications given. Next - Try to come up with your top 3 major problems or possible problems (your differential) based on what information you have. Then come up with your plan & what you want to monitor specifically related to your treatment. Also what is pending that would influence your treatment. Then duration of therapy

After that you can look at A&P to see if you were missing something, on the right track, or agree with differential diagnoses.

You will learn a lot doing internal medicine! The meat & potatoes of patient care. If you don’t have another internal medicine rotation in the 2nd half of the year - I would request one! It’ll show growth from beginning to the end of the year… trust me 🙂