RK – The Clinical Student

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Its been said that the didactic portion (basic sciences) of medical school is more about “book smarts” while the clinical portion utilizes one’s “street smarts.” Among the latter is an astute mastery of dealing with people – patients, fellow medical students, nurses, residents, attending physicians, etc. I know I’m not going to be liked by everyone… it’s only human nature. But there are three things which I wish to make the cornerstone of my clinical persona.

First and foremost, I will embrace the “I don’t know the answer, but I’ll find out ASAP” approach to being a student. During my first rotation, there’s a slim chance I’ll know the clinical approach for… well… most things. Though I may understand the pathophysiological mechanisms underlying a given disease, I’d imagine that most attendings don’t care if I know that an impinged median nerve can lead to tingling in the hands. They care about a.) what else could it be? b.) what tests, if any, should be ordered?, and c.) what’s the treatment?

This brings me to my second point. I will be a strong proponent of evidence-based medicine. Let’s say a patient comes in with primary syphilis. Before jumping on the routine penicillin-based regimen, a quick search of the literature may offer an even cheaper option. Or one with less side effects. Or a single drug which can treat the patient’s syphilis and other ailment(s). Medical research is advancing so quickly that tried and tested treatments will become obsolete during my clinical years. It’s my responsibility to be on the forefront of this research and share my findings with others.

My final point is something which I learned during my preceptorship experiences. I will listen to my patients. It’s easy to say but difficult to actually do in practice given how hectic rounding can get. Patients teach you things about the human condition, about your bedside techniques, about how to address the needs of different cultures, and about how to become a better physician overall. Each patient encounter is a learning opportunity, and at this point in my training, a chance to make mistakes. What should I have asked Mr. Smith about that chest pain? Was there something more Jane Doe wanted to tell me about her pregnancy? Each patient is different, so their care should be tailored to meet his/her needs. The best way to learn how to do this is to simply listen. 🙂

Now for the things I will try my absolute best not to do.

  • Show up late. Ever. Streaming lectures in the basic sciences has spoiled me. 😉
  • Try to “one up” my teammates. I don’t want to be labeled as the “gunner” or “sniper” in the group. Clinical medicine is heavily reliant on teamwork to ensure efficiency and appropriate procedures. I simply want to be a humble, reliable, and productive member of the team who seeks collective progress rather than individual accomplishment.
  • Be lazy. There’s so much material, and the shelf exams are too difficult to put everything off till the last minute. I was really good about being on top of assignments in undergrad, so I’ll need to rediscover that mentality very soon.
  • Be a hermit. Interacting with others outside of the hospital will keep me sane and happy. As will cheesecake. And sports. :mrgreen:

Overall, I want to be that teammate that any of my classmates would want to work with on any rotation. I want to empower them to reach their maximum potential, and in the process, reach mine too. We’re all in this together! 🙂

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