As of this month, I have formally started upon the clinical retraining plan which was drawn up for me over a year ago by the organization which performed my clinical competency examination. The first stage of this plan involves me essentially being an apprentice to a practicing internist. Which seems to be going fine, even though I am very slow at charting now because of having to learn the EHR software. (For instance, tracking down the results of a patient's prior diagnostic study can involve searching 90 different folders spread across 3 separate tabs—and that is just the section for prior diagnostics!)
Also: now, instead of dictating one complete note to a medical transcriptionist as in times past, I have become the transcriptionist, typing separate notes (one for HPI, one for assessment & plan) into the system. All else is generated by dropdown menus and checkboxes, the navigating of which I find very tedious indeed. Apparently, in this medical world I have returned to, the medical transcriptionists are now out of jobs; the physicians transcribe their own notes at no extra pay; and I guess the transcriptionists' former salaries are now paid out to the EHR vendor for use of the software? Pretty neat trick, that. I, for one, miss dictating a coherent narrative. Taking this away seems to also take away part of my diagnostic thought process, and unfortunately this is in no way made up for by the abundant menus and checkboxes. Still, I realize I must adjust to this new way of managing information, because the system will certainly not adjust to me.
Speaking of diagnostic thought process, I am finding that all the basics are still with me but my fingertip knowledge is sometimes lacking. Here is where being apprentice to the good doctor really benefits me, because she is bringing me up-to-date on all the latest. Quinine sulfate is no longer used for leg cramps and is now off the market in this country? Who knew? These are the sorts of factoids I need to add to working memory now.
Of course, starting retraining has brought new expenses: I have just paid out in excess of 5K for a one-year malpractice policy. Also, I must pay the monitoring organization $650 monthly until they tell me it is time to stop. As usual with this reentry process, it remains to be seen which is going to happen first: I reenter medicine as a practicing physician OR my resources run out before I reach that point. I have a feeling it is going to be a near-run thing in the end. Stay tuned.