I was very excited to begin shadowing Dr. Julia Korenman ‘78, a gastroenterologist at Digestive Disease Consultants in Rockville, Maryland. I arrived at her office at 7:45 in the morning. Before we did anything, I had to sign a privacy form as is standard in all hospital settings. Then she introduced me to some of the partners and nurses and showed me around the clinic. Since I was a little early, we had some time to talk about why I was interested in gastroenterology and what my future plans were in college. Next, she told me that she would be meeting with patients all day and showed me “our” schedule for the day. I was quite amazed by how many patients she saw each day. The patients were usually scheduled for 15- or 30-minute time slots and Dr. Korenman’s schedule only had an hour break for lunch, assuming everything goes perfectly according to schedule. Before I saw each patient, Dr. Korenman asked the patients if they were comfortable with a Pre-Med student observing their session. In case they were uncomfortable with having me in the room, Dr. Korenman gave me some reading material on common gastrointestinal diseases: celiac disease, hepatitis B and C, Irritable Bowel Syndrome (IBS), ulcerative colitis, Crohn’s disease, reflux disease, etc. The main reason I am interested in gastroenterology is that I had previously done research on IBS and really wanted to interact with patients and hear first-hand what it was like to have IBS. Sure enough, throughout the day, there were several patients with IBS and other inflammatory bowel diseases. Many of the patients were there for either endoscopy or colonoscopy consultations or follow-ups; nonetheless, I was very lucky to observe a wide range of GI diseases that day. I saw how Dr. Korenman tried to diagnose certain patients, performed abdominal examinations, explained the preparation and risks of endoscopies and colonoscopies, and checked if treatments were working. During the consultations, Dr. Korenman would often turn to me and clarify certain terminology and explain to me what was happening; after each meeting, we would go back to her office and I would ask her questions about certain things that I did not understand like proton blockers, concierge medicine, etc. Meanwhile, she also had to do dictations for each patient to send to the patients’ primary physicians. I was really amazed by the fast pace of the job. Even at lunch, Dr. Korenman was working on catching up on dictations, but we did have some time to just talk about Princeton, her medical career, the business aspect of private practice, etc. After lunch, we continued to see patients and I was able to see some other aspects of what it means to be a doctor. I learned about how doctors have to handle delicate and emotional situations and deal with complex new treatments with significant side effects. By around 4:30 pm, we had seen all of Dr. Korenman’s patients for the day. I really enjoyed being exposed to so many different aspects of what it means to practice medicine; it was certainly a lot to take in. I was really excited to watch the procedures (colonoscopies and endoscopies) the next day.
Tuesday, January 10th, 2012
Today, I arrived at the Gastrointestinal Endoscopy Associates Office, where Dr. Korenman performs procedures. When I got there at 8 am, I was required to sign another privacy form. Shortly afterwards, we went to the procedure room, where Dr. Korenman introduced me to the anesthetist and technician. The first two procedures I saw were endoscopies and I was able to compare and contrast the differences between healthy and inflamed upper GI tract. During the procedure, the patients are sedated; the anesthetist told me about the anesthesia she was using. I was able to not only see the vocal cords, esophagus, stomach and duodenum, but also see how sleep apnea can complicate an endoscopy. During the procedures, Dr. Korenman explained to me what she was doing and what we were seeing on the screen; we also had time for me to ask questions and the significance of nodes or to just talk about medical school, Princeton courses and how Princeton has changed over the past few decades. After each procedure, Dr. Korenman would fill out some forms on the computer and then we would inform the patients of their results, make sure they were feeling okay, and see if they have any additional questions. After the endoscopies, I was able to see several colonoscopies and a “double” (an endoscopy and colonoscopy). During the colonoscopies, we were able to see how effectively the preps worked at emptying the lower GI tract. Then, Dr. Korenman explained the significance of diverticulitis and hemorrhoids. I was also able to see the method for biopsies and removing colonic polyps. Before I knew it, we were done for the day.
During these two days, I was able to witness both consultations with patients and procedures. I found both days to be engaging in their own way; they offered two very different perspectives on practicing medicine. I found this Princeternship to be a very worthwhile experience. I accomplished my goal of learning more about gastroenterology and seeing first-hand how practicing medicine is very different from classes. After these two days, I am certainly more motivated to pursue a career in medicine and would strongly recommend this opportunity to students, who have not seen what it means to practice medicine. I would like to thank Dr. Korenman for taking time out of her busy schedule to accommodate me and for showing me what a career in medicine has to offer. In addition, I would like to thank Career Services for making this program possible.