Cardiology Elective @ DMC - 2 weeks

On Friday I finished my 2 week cardiology elective at Doctor's San Pablo. I had such an incredible time rotating with Dr. Weiland- he is probably one of the best in this field. To give you an idea of how cool it was, the very last thing we did in my 2 weeks rotating there was watch Dr. Weiland do a thrombectomy and angioplasty on a man who just had a STEMI at the gym 40 minutes prior. STEMI= ST Elevated myocardial infarction (heart attack). I glanced at the ECG in the emergency room, which showed the most classical anterior MI with ST elevations in leads V1-V6 and AVL, with reciprocal ST depression in the inferior leads. On the cath monitor we could see that the LAD (left anterior descending artery) was 100% occluded when he started, with mild disease in other coronary arteries. When Dr. Weiland was done, we could see on the monitor that the blood flow had been restored completely. After the procedure, Dr. Weiland asked the patient, "Do you have chest pain?" and the patient responded, "What chest pain?" I would say that is a job well done :)

On this rotation, I did get to actively assist with patient care. One of the coolest opportunities I had was to shock a patient back into sinus rhythm. The staff makes sure the patient is sufficiently sedated and you set the biphasic system to the amount of joules you want, clear the area, charge the defibrillator, and press shock- pretty simple. The patient is jolted awake and sinus rhythm is the desired result.

For those of you considering doing cardiology at DMC with Dr. Weiland (which I highly recommend), read on. On the cardiology service at DMC you see on inpatients during the morning, write SOAP notes, and then gather for rounds with Dr. Weiland around 8:30am. During the course of the day you see inpatients on all floors, in all departments. He is constantly getting phone calls and needing to be in 3 places at once, but he balances all of this very well and stays very grounded- its a great example for people who may want to go into a specialty where their services will be in high demand. You also visit the clinic to see outpatients in the afternoon sometimes. Weekends are free, but plan on being in the hospital until 6:30pm or so each night, wear comfortable shoes, and bring snacks because you go long periods without being able to have a meal. You will see lots of great pathology at DMC and you will be able to learn about cardiovascular disease prevention, management, and rehabilitation.

Bottom line, 2 weeks is just NOT ENOUGH TIME for a cardiology rotation. I don't even think 4 weeks is enough. I'll just have to try to get much more exposure to cardiovascular disease management during my FP and IM rotations this year. During 3rd year we don't have much time for electives. I used my vacation to study for boards, did a 4 week OMM elective, so the only choice I had was to split up with month into 2 electives. On Tuesday I start PM&R with Dr. Lewis in San Francisco. I heard he mostly does outpatient care with an emphasis on musculoskeletal rehabilitation. Should be very interesting! Stay tuned for a report on that in a couple of weeks ;)