Last fall I went to a talk run by the UofT Internal Medicine Club and at the end of the session there were sign ups for medical students interested in being matched for a shadowing experience with physicians from various non-surgical specialties.  I can't remember what specialties I wrote down, I think it was internal medicine as a first choice (e.g. general internist) and then neurology as a second choice.  I wasn't really thinking too much at the time.

Well I got hooked up with a neurologist (sign, anyone? haha) at Sunnybrook Health Sciences Centre.  I'm not going to mention his name out of sake of privacy, despite the fact that I thought he was fantastic and I thoroughly enjoyed the experience.

It was my first time going to Sunnybrook, and I was using their shuttle bus service to get there directly from Women's College Hospital (which is downtown and fairly close to me).  Because I didn't have a pass for those hospitals, I had to get a bus pass directly from the hospital, and the person who gave me the pass told me to just tell the driver that I needed the pass for the round trip (even though the pass says it's only meant for one trip).  Obviously, when I hop on the bus, the driver tells me no, I can't use it for a round trip, despite me giving the name of the person I talked with and everything (they were just being responsible of course, so I can't really be upset or anything).  Good thing my buddy had negotiated another pass for me last week from Sunnybrook!

While hospitals I had been to downtown were basically one, large, vertical building, Sunnybrook seemd like one, really long, horizontal building.  The entire hospital was broken up into multiple wings.  People seemed very nice.  When I first walked into the main entrance and started looking at a map of a building, someone instantly asked me if I needed help.  There were signs though, so I was able to find my way around pretty well.

Found my way to his office area, where I ran into several neurology residents.  They kindly paged him for me, and I was told to head back downstairs to his clinic.  Upon arriving there, I was told to take a seat and wait while he finished seeing a patient.  While there I ran into another student from my class who also turned out to be shadowing the same neurologist today.  Somehow I remembered her name even though I think I only met her once, months ago, during orientation week.  Too bad my memory is terrible when it comes to school material.

When the neurologist was finished with his patient, we exchanged pleasantries and he took us up back up to his office to discuss his resident's patients before beginning "rounds" for the day (i.e. checking up on patients).  In total there were five other individuals, among them three adult neurology residents, one pediatric neurology resident, one internal medicine resident (doing a neurology rotation), and a 4th year clerk (doing her neurology elective).  The residents had each seen a different patient and had taken their history and performed neurological exams on them.

One by one the residents described their patients and their findings from taking histories and doing neurological exams.  All the while the neurologist would be taking notes on anything he thought was interesting/important, and occasionally asking questions and making some of his own points.  The other residents would also chime in with thoughts and questions.  It was essentially a team working together to solve the case and reminded me of House.  Watching this type of environment unfold made me want to become a clinician-educator in the future even more - being able to play House everyday would be awesome.

After discussing the patient, the team would head to visit the patient.  The neurologist would talk to the patient and ask him/her about the problems he/she was having, and then do a few neurological exams of his own to try and further pinpoint where the problem could be stemming from.  All the while, the team would occasionally discuss possible reasons for what was happening.  By the end the team would agree on a next step of action, such as getting a MRI scan done to gather more information.  Some types of cases we saw included a man who all of a sudden had extreme pain in one of his legs (and the team tried to pinpoint where possible nerve lesions could have occured to cause this), a man who had a stroke and lost his ability to speak, and a woman who had a stroke and had trouble thinking backwards.

In total, we saw five or six patients over the course of about three hours.  Keep in mind that this includes discussion time between patients.

I really enjoyed the environment.  The whole team were pretty relaxed and chill overall, which is the type of environment I want to work in someday.  The neurologist had a pretty good sense of humour, and one of the residents was particularly funny.  One other positive was that they all finished sometime between 5 and 6pm.  It was nice knowing that when you weren't on call, you could lead a pretty normal life as a resident (and even as a neurologist) in terms of hours.

I plan on doing a bit more shadowing this year, including some other neurologists and probably some other specialists in internal medicine.  Hope you guys enjoyed this trip report!