Specialty Profiles

What it's like to be in adolescent and internal medicine: Shadowing Dr. Rohr-Kirchgraber

. 6 MIN READ

As a medical student, do you ever wonder what it’s like to specialize in adolescent medicine? Here’s your chance to find out.

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Meet Theresa Rohr-Kirchgraber, MD, an associate professor of clinical medicine and pediatrics at Indiana University, executive director of the university’s National Center of Excellence in Women’s Health and a recent recipient of the Joan F. Giambalvo Fund for the Advancement of Women. She won the prestigious award for a project she’s conducting on physician suicide.

Check out Dr. Rohr-Kirchgraber’s thoughts on internal and adolescent medicine as a special part of AMA Wire’s® “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties.

Read these insights to help determine whether a career in adolescent and/or internal medicine might be a good fit for you.

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“Shadowing” Dr. Rohr-Kirchgraber

Specialty: Adolescent and internal medicine

Practice setting: Academic medicine

Employment type: University and large group practice

Years in practice: 24

A typical week in my practice: I split my time 50-50 between clinical and administrative duties.  I run a number of different programs, so every day is different. I am up at 5:00 a.m. and I usually get to work by 7 a.m. [I’m] usually home by 7 p.m. and do a lot of things at home on the computer, but I love it. It is a great mix of patients and leadership. I am always teaching and have a learner with me for just about every patient. I am on call about 8-10 weeks per year.

The most challenging aspects of caring for patients in adolescent and internal medicine: The most challenging aspect of caring for patients is not so much what goes on in the exam room but everything that got the patient there. Working with a patient means you work with their family, community, education, socioeconomic status plus lifestyle choices. I never know [who] is going to greet me when I open the door to the exam room, but being part of their lives is a blessing.

It is challenging to work on all the social ills as well as the medical and psychological problems, but with every challenge comes reward. Sometimes it happens quickly, and other times, it takes years.

It is also challenging to make the work environment pleasing for all of our staff and keep them working to their level of expertise. When your staff are happy, your patients are happy!

Three phrases that describe the typical physician in adolescent and internal medicine: Enjoys detective work, likes to listen and is a leader in the community.

Research shows that gender may impact specialty choice or life in certain specialties. Based on my own experiences: Gender [did] not impact the choice of my specialty; however, it impacts the culture of the specialty as more women work in primary care. Gender does seem to play a role in the take-home pay of those physicians in my specialty, and that is something we need to continue to work on.

What I think about assessing my lifestyle in these specialties: No one can ever tell you what it will be like, and if they did, you would not believe it anyway. The excitement of medicine is ever present, as is the self-doubt, the life-long learning and the little “thank you, doc” that makes your day. Medicine is a passion and a career, not a job. I hope to continue the enthusiasm for the next 30 years!

The main skills every physician in training should have for adolescent and internal medicine but won’t be tested for on the board exam: Compassion and enthusiasm for the learning process is one thing that will hold you in the profession for your life.

What we also have to learn is how to let go. Let go of the fact that we are not always the smartest. Let go of the thought that others make mistakes but not me. Let go of the idea that what you want for your patient is what they want for themselves. Let go of being “Wonder Woman.”

Enjoy the thrill of making a correct diagnosis, helping a family and patient come to terms with their illness, and enjoy being an example of healthy living. Enjoy your life and your family!

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One question physicians in training should ask themselves before pursuing adolescent and internal medicine: Why [am I doing] this? Is this a job or a career?

Be prepared for the bad as well as the good and ask yourself whether you have a good support system and whether you know where to look when you will need help or a shoulder to lean on. Will you be able to consider other options when one area stops working for you? Are you adaptable? Look now at who you lean on. Will you be able to have similar people or organizations in the future?

Three books every medical student interested in adolescent and internal medicine should read:

  •  The Medical Detectives by Truman Talley. This is a great book about public health and tracking down diseases.
  •  This Side of Doctoring: Reflections of Women in Medicine by Eliza Chin, MD. [In this book], [more than] 100 women speak [about] the triumphs and challenges of practicing medicine. I give this one to all of my mentees.
  • Doctor of the Heart by Isadore Rosenfeld, MD. This is a great read [covering] some of the history of medicine and great cases.

Online resources students interested in my specialty should follow:

Additional advice for students considering adolescent and internal medicine: Keep an open mind about internal medicine as it will surprise you. There is so much you can do with it and it gives you a broad education. Internal medicine is a great jumping off point and has led me in directions I never anticipated.

If my life in adolescent medicine were a song, it’d be: “Oh What a Beautiful Morning” by Richard Rodgers and Oscar Hammerstein from Oklahoma!, a classic musical.

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