Hello everyone! It’s been quite a while since I posted (almost a year!). My schedule has been quite busy with classes and research, so I decided to take some time off of blogging. If you’d like to follow along on my journey, click on the “Follow” tab to the right to subscribe via email and get updates every time I post! These next 2 blog posts are going to recap my 3rd year of the 6 year BA/MD program.
White Coat Ceremony
In August 2015 I received my white coat! Traditionally, this ceremony occurs at the beginning of one’s first year of medical school. In the 6 year BA/MD program that I attend, the White Coat Ceremony takes place at the beginning of Year 3. It inducts you into medical school and impresses upon you the honor and responsibility that you have as a physician in training. At this time, you are placed into the unit that you will work with for the next 4 years — both in clinic and on your internal medicine rotations (DoRo). Everyone in the unit has an office in the same space, and you will spend time studying and interacting with these people even outside of the hospital. I have heard upper years describe their units as close friends and even family; going through the White Coat Ceremony and being assigned to a unit is something that many people look forward to during the first 2 years of the program. This day really helped establish the fact that I’m in medical school, and was both a rewarding accomplishment (for having completed the first 2 years) and an exciting encouragement (for completing the next 4 years of medical school).
Clinic has by far been one of the best learning experiences yet. The early clinical experience is one of the strengths of UMKC’s 6 year program, and something that many people state as a reason they came to this program. Beginning in Year 3, you have internal medicine outpatient clinic one morning a week. We see patients who have chronic conditions, ones who need to establish a primary care physician, and patients who visited the ED and were scheduled for an outpatient follow up appointment.
The patients come into clinic and are roomed and have their vitals taken by a nurse/MA, along with an overview of any medication changes, travel, etc. since their last visit. The medical student then goes in to see the patient, and we take a complete history and perform a physical exam. After that, we present the patient to our attending (docent) in the standard SOAP format: Subjective history and review of systems, Objective vitals, physical exam, and lab/imaging results, and our Assessment and Plan. The attending then goes back into the room with us, asks the patient questions, performs an exam, and discusses the treatment options and plan with the patient. The medical student then writes the visit note (which is reviewed by the attending) so that there is a record of what occurred in the visit and the plan for future visits.
You have a unique opportunity as a medical student in clinic. You often have more time than the doctors to spend with the patient (since you only see a few patients and they see 9-12 per morning), and so you can delve into some of the social and emotional aspects of their conditions. You can also take time to explain what is happening with the patient if they are confused about anything. Being able to go into the room first and do a history and physical allows you to present the attending with the main concerns that the patient has, and thus can aid the visit in going smoothly.
Being able to see conditions that you learn about in class (diabetes, hypertension, osteoarthritis, etc.) is such a wonderful learning tool. In class you memorize the information and understand how the disease works, and then in clinic you see how the disease presents in a patient. Conditions are much more memorable once you have a face to associate them with. Clinic also helps pull together the various components of a condition — patient presentation, physical exam, lab and imaging results — and you learn the next steps to take in evaluating, treating, and managing the disease. When you apply the knowledge you’ve learned in class to a clinic case, it forces you to integrate information from several classes and points out what you know and what you don’t know. I learn something in clinic every single week, and even though I often feel like I have much more to learn, it’s rewarding to see a similar case in a later clinic visit and know more about evaluation and management for that disease.
I have greatly appreciated having wonderful physicians who are willing to teach medical students. Working with various physicians (though you are assigned to one attending/docent primarily) lets you see different manners of working with patients and counseling them in their medical care. The doctors we work with will question us regarding health conditions and treatments, and teach us more about clinical scenarios. As I said before, clinic has been one of the best learning experiences thus far — I’m really looking forward to January 2017 when I’ll start clinical rotations!
To be continued…
Part 2 of this post will discuss my classes from Year 3: Neuroscience (my favorite), Microbiology, and Pathology I and II.