Day in the Life of a DOCTOR: THE CLINIC

Morning guys. I’m Siobhan, a third year medical resident. I’m heading to the general internal medicine rapid assessment clinic and we’re gonna be seeing a bunch of patients together. So in this clinic we’re seeing patients who need to be seen quickly. Often they’re being referred by the emergency physicians. These patients aren’t sick enough to get admitted to the hospital, but they need to be seen by specialists soon. Or they can be sent from their family doctors as well. So I’ve got two jobs today: One is actually seeing patients myself, but I’ll also be reviewing cases with the junior residents before we go and chat with the attending physician. What makes this clinic so cool is that we have a full interdisciplinary team here. So we have social work and pharmacy and physical therapy and occupational therapy all right here to assist patients and they don’t have to then have a million different appointments. So this first patient presented to the emergency department 2 days ago and they were feeling really weak at that point. So they did blood work and they found the liver enzymes were quite elevated and it wasn’t really clear why, but the patient wasn’t sick enough to need to get admitted to the hospital, which is why we’re seeing them here today. Okay, so after talking with this patient there’s still a number of things that it could be. I’m starting to favor an infectious cause, a hepatitis because of the patients traveling history and never having had vaccinations for hepatitis. But it could be related to alcohol and I mean it could be like an autoimmune cause, it could be something rare like hemochromatosis. I don’t really think that’s what it is, but we need to do a bunch of blood work to get a better sense of het progression and the cause of this. So we’ll be bringing him back in a couple of weeks to see where we’re at at that point. But one thing that I noticed is that this patient is often being referred to specialists in the past, but unfortunately hasn’t actually shown up for those appointments and I think that may have something to do with financial or mobility constraints. So I just wanna head over and talk to our occupational therapist who may know some programs that he can get him enrolled in. Hi Amy. – Morning Siobhan. Do you have a moment? Absolutely. So I’ve just seen a patient who’s missing a lot of appointments to specialists and I just don’t know if this is mobility, financial. I’m hoping you can help. Oh absolutely, I’m happy to. -How’s cognition? Good question. I think okay, but he might just be compensating. -Does the person live alone? Yes. -Okay, so maybe it would be useful. I’m happy to look at them. I can look at their their gait,, their balance, their strength, so we could get kind of a picture related to that. And maybe cognition would be useful to see whether or not they’re missing appointments because they’re just not remembering. -That would be fantastic. Do you have time now? -Absolutely. And if you need therapy services, then I can put my CCAC in. Thank you so much. – You’re welcome. So for each patient that you see as long as someone’s not waiting I like to try to dictate the note quickly so that I don’t get behind. It’s just a little bit faster than writing it all by hand. Today’s date is July 9th 2019. This is Siobhan dictating. Hi Siobhan, I’m ready to review this next patient. Oh awesome. Who did you end up seeing? Okay, I went to see a 52 year old gentleman who has been referred to us from the emergency department for shortness of breath and bilateral leg edema. So he went to the emergency department originally because he was having some difficulty breathing and he noted that he had a couple of months of progressively worsening leg swelling. Mm-hmm. In the emergency department they gave him some lasix and he started to feel better. So he’s been sent here now for further evaluation of why he’s been having these symptoms. -Okay. Okay great. Okay, great job. Let’s go and find Dr. Panju and we can just go to review and then see the patients we saw, they’ve been waiting for too long. Dr. Panju… Oh I need a chair. Gonna wheel over and find you. So Wendy did a fantastic job presenting about a 52 year old man who is coming to see us today from the emergency department because of bilateral leg swelling. It’s been progressive. It’s been associated with shortness of breath that’s worse when he is lying down, he actually wakes up gasping for air. And when he was in the emergency department, they gave him some lasix which has helped his symptoms quite a lot. -Okay. Um, did you do a chest x-ray? -He had one done in the emergency department. Do you wanna…. -Yes, let’s look it up. -Okay, let’s pull it up here. -Alright, so Siobhan, what do you see when you’re looking at that? -He’s got some vascular redistribution in addition… Looks like some opacifications at the bases, it looks like pleural effusions. -No, you’re right. It does look like there is some evidence of some vascular redistribution, absolutely. Let’s go into the room, we’ll all go together over there. I’d like to see you explain to the patient our plan and what we’re gonna do next. At the same time I would also like you to demonstrate for me when we’re going to see the patient your examination for volume assessments, specifically your cardiac exam for volume overload as we’re seeing this patient. I think it’s an important exam to identify different causes of volume overload for this, so let’s get going. -Okay, fantastic. So the next patient that we’re seeing is an elderly woman who’s coming in apparently feeling quite dizzy. She hasn’t fallen or blacked out and I’m not quite sure. Does that mean she’s feeling off-balance, does it mean the actual room is spinning? And what happens when she gets dizzy? So there are a lot of questions to ask her, which will help us figure out what’s going on. As I walk into the room, I meet a very thin frail looking elderly woman. Just a few minutes into her conversation I asked her what medication she’s taking. So she bends down to get her purse and I’m so shocked as she pulls out 2 huge ziplock bags full of prescription bottles. There are at least 7 different doctors prescribing her these medications and honestly it makes me wonder if anyone has been looking at the bigger picture and all the possible interactions between these medications. So I definitely want to see if our pharmacist is available to help sort all of this out. Hi Alice, do you have a moment? -Yeah. -Okay, fantastic. I just saw a patient who is coming in with dizziness and she has about 20 different medications. -Twenty?! -Yes, and I really think that this is probably a big part of it. –Definitely. Yeah, we need to have a look at that. Is the patient here? -Yes, just down the hall. -With a bag of bottles? -Mmm-mm. -Oh, excellent. And I can come and meet you in like 30 minutes, like I can see her now. Yes, oh it would be amazing. Sometimes they may have the same medications, like duplicates of the same medication or like they may be taking over-the-counter medications. So who knows what she has. So definitely, I can help you with this. -Thank you so much, this is amazing. -No problem. Okay, I’ll go see her now. So now we’ll meet with dr. Panju, the attending physician, to finalize a plan and go and meet with the patient together. Alright, so finally done with all of my notes. We even had a chance to teach the junior residents a good shoulder exam and now it’s time to go home. Everything’s been t’d up. It’s been a really nice day. So if you guys have any questions about what it’s like to be a doctor, what it’s like being in clinic, then definitely subscribe. Let me know, I love hearing from you guys. And then otherwise, I’ll be chatting with you next week. So bye for now.

100 thoughts on “Day in the Life of a DOCTOR: THE CLINIC

  1. Great job on this video, it's nice that there are locations for patients to go to get help and not get lost in the schufful of papers and appointments nice have the different teams to assist not only the patients but the doctors nice job as always Jim RN

  2. This girl is probably the most well rounded individual I have ever witnessed! You’re gonna make some guy a very lucky man one day! Keep up the good work! Love the videos

  3. Do you have a specific upload schedule? If so when do you upload. I may have just binge-watched all of your videos 😂

  4. Wow!! You are so nice and I wish I lived in Canada or you lived here. I feel like your disposition is perfect for a doctor!

  5. Love seeing all these strong, intelligent women in medicine!💪🏻 I’m a student nurse/CNA (also another strong, intelligent woman in medicine 😉) and I love watching your videos!

  6. This video was posted 2 days before my birthday! Also, congrats on your 3rd year!! So proud❤❤💜

  7. i have a question 🙂 even though you guys are doctors, do you still go to regular doctors appointments ?


  9. omg 3 year!!!!! i remember when you used to say a "a first year medical resident" ibe been watching your videos since then. ilysm your my favourite youtuber xxx

  10. Thanks to you and all your colleagues for showing us what it's like as a resident. Videos like these help solidify my career choice. Hoping one day to be where you are. Again thank you!

  11. I just found your channel and am enjoying your videos! Two of my best friends just started their first year of residency; one in general surgery and another in emergency. And now I have some insight into how it all works and what their day looks like! 🙂

  12. Have you worked in psychiatry so far or had a placement there? I work in a psychiatric acute ward and it would be interesting to see how you work in a different country!

  13. I’m a premed student and have only about 2 years left to get my bachelors degree and then take the mcat then apply for med school 🥺😭❤️ I can’t wait this is all I’ve ever wanted. My kids will be a little older then. ❤️

  14. ahh congrats i can’t wait till u can say a fourth year medical resident!!! i’ve been watching since u were a first year medical resident! 💙 keep up the great work

  15. I love your videos! You have such a positive outlook and it makes me look forward to my future career in nursing!

  16. congrats on your third year! i love your infomative videos despite me having no aspiration in the medicine field #futurefinancialanalyst. i love that you actually have a passion for what you do and it's visible that you're an amazing person. i wish nothing but the best for you!

  17. I don’t get what residents mean like first year Third year also what things do you have to do to become a doctor

  18. Hi! I've been watching you for a while! I really want to go into med school and become some sort of doctor.. when you're training to be a doctor in a hospital, do you have to practice in an OR?

  19. That hospital is the best fricken hospital ever..for so many reasons. LOVE it. I donate to it all the time.
    Not sure if you say your locations on these so I didn't want to say the name of it.

  20. I'm not sure if we have these clinics in the states? but oh my gosh that'd be helpful. lots of my patients in the ED have no insurance or follow up and often times we have to admit them because of that. this is such a wonderful clinic!

  21. Great videos Siobhan! I just starting watching last month. I’m also an avid fan of medical dramas like House (the best!), Grey’s Anatomy, and The Good Doctor.

    In a future video can you rate the authenticity and accuracy of the shows and debunk common misconceptions in medicine?

  22. OMG laSIX as in six hours! I never knew that's why it was called that! I feel so silly for not knowing that. Love your videos btw. I was very much thrown off by the "third-year" intro…can't believe it's been that long!

  23. Hey! I'm a newer subscriber, (however I have done my fair share of binge watching) 😂 and I absolutely love your videos! I adore your intro in your videos, watching you go from first year to second and seeing the beautiful smile and excitement in your eyes when you said third year warmed my heart! You're so beautiful and intelligent and I'm so excited for your engagement by the way! I'm currently a pre-vet major, and you still inspire me to follow my dreams in the medical field. Much love! 💜

  24. Is there like rooms /dorms , you sleep in 4 the night if u need to keep a eye on a patient? Idk im curious XD, anyway love from oklahoma,usa

  25. Respiratory Therapist here and I enjoy watching your blog. I feel I have learned alot from your videos! I especially liked your video on nephrology. Learned alot. I've been contemplating on going back to Physician assistant school…..

  26. New subsriber here just stumbled across your videos, your really gifted I'm a nurse, and wish I worked around more medical doctors like yourself

  27. Thank you for shedding light on occupation therapy! I'm an OT student and hope to be working in a hospital too some day, so that was awesome to see 😊

  28. I’m only 14 but I honestly want to become a surgeon so bad how many years of schooling does that take? And how many surgery’s have you been in

  29. I wonder do you follow other you tube doctors? There is a british doctor I follow , some times look at zdoggmd, and a few others. I also follow chemists like the periodic tables channel and Myles Power. I also look at biologogists like the Credible Hulk on facebook.

    Thanks for your input.

  30. What are clinicals in med/nursing school like? I’m a second year nursing student and nervous about the clinicals!:)

  31. Girl, how do you have time to vlog! I’m a Physician Assistant and ain’t no one got time to vlog! Haha.

  32. Hey! Im just wondering, how are you allowed to film so much of the hospital staff and meetings etc in such a confidential environment? I want to go to med school so understand that you’re not filming patients, I just wonder how you can film so much of the staff and hospital in your vlogs! Do you ask their permission? Thanks!

  33. I had serotonin syndrome to the point that I was on life support! Doctors need to be careful about over prescribing!

  34. I am a first-year BSN student, and I am legit happy because I am starting to understand medical jargons!!

  35. Congrats for your third year! And keep up the hardwork, If you don’t mind, could you tell me how was your medical school? How long does it take from the beginning of medical school until you get to your actual patient? Thanks !

  36. congrats on third year. For the patient with swollen legs did you eventually end up doing an ecg? You would probably find a heart murmur which would suggest a leak in one of the four valves, That would explain his lack of breath especially when laying down and swollen legs with fluid retention.

  37. Hi when I am older I would love to have the same job as you could you. Tell me what being a doctor is all about and how you became a doctor .

  38. Hello! You are such an inspiration to me (and to so many others I am sure!!!! I am amazed at the fact that you are a second year resident that also finds time to film and edit videos to EDUCATE your viewers and raise awareness on a lot of medical topics. I hope you know how amazing you are as a human being! I would LOVE to see a video of you explaining how you manage to film vlogs at work, how did you bring it up with your co workers /bosses, etcetera! Keep up the good work! 🙂

  39. I feel like I really want to be a doctor more than pretty much anything and I think the medical field is incredible but I feel like I have another passion that kind of makes me second guess going to med school. They both have equal pros and cons and I don't want to regret my decision

  40. Hai, i been emergency medicine for 3 years. I love being in the in emergency medicine. But my senior doctors are not helpful as yours. I hope to be as happy as you are.

  41. I would like more informative information. I’m currently a nursing student wondering if I want to go to medical school. And is one of your blogs you broke down an acronym that helped you remember the indications for dialysis. I personally really enjoyed you giving that extra info!

  42. Please guys i need the name of the song always used in the beginning and the one playing in the background the first few mins in this video pleaaasee

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