You’re Only Old Once

There are no problems – only challenges and opportunities. -Dr. Elliott.

My last rotation was originally scheduled to be my 6-week long Internal Med rotation, but due to the nature of the clinic (Concierge) and personal challenges that my preceptor was dealing with (dissecting aortic aneurysm), I knew that this rotation would be challenging for me and the clinic to produce a challenging and complex Internal Med rotation. Consequently, I ended up turning this 6-week Internal Med rotation into 2-weeks of Geriatric medicine [Primary care elective] – and thankfully this worked out well for all involved parties.


  • Amazing preceptor. My preceptor was one of the most intelligent and respectful doctors I’ve yet to encounter. An ex-Marine Corp, he was tough, knowledgeable and extremely kind to his patients. Despite his own medical challenges, he made it a point to hold morning didactics at 8am daily and teach on any subject of my choosing.
  • Learning about Geriatric Medicine. This may not seem like the most scintillating topic in medicine, but oh man, will it be important when we are in practice. If you’re working in primary care, this will be a significant part of your patient population. Understanding what is normal vs abnormal in aging and how to deal with topics like Dementia and physiologic changes in aging, will become essential to your practice.
  • FREE LUNCH. A touchy subject, but lunch was provided by drug reps. You can read about increased transparency between pharmaceutical companies and private practices at the Sunshine Act.


  • Limited number of patient interactions. My preceptor acknowledged this from the start, he made it clear that because they are a concierge service, I would not be able to see patients unless they were comfortable with a med student – and many were not.
  • Med-U Modules. I did a LOT of Med-U modules on this rotation. Good stuff, but Real Patients > Online Cases.

Best Advice given on this rotation: stick-your-nexk-out

Like any slow-moving med student, in order to progress in this field, I learned that you gotta stick your neck out! The next two years of our training is the time for us to make diagnoses, formulate treatment plans and be WRONG without any consequences! Well sure your preceptor might think you a dolt, but “your” patient is still alive and not suffering from your mistakes, but when we are doctors (who?…US?!!!) making these mistakes have real consequences. So it’s better to make them now, STICK YOUR NECK OUT, be WRONG, learn from your mistakes, and keep moving forward. 


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