Over the last few years, in part spurred by student interest, Stanford has offered a “Capstone Clerkship.” The idea is that at the end of medical school, students are rusty. In a few short weeks, we not only have a few extra initials after our names, but we have real live patients to care for. The stark transition in responsibility is a cause for anxiety in many, if not all, graduating medical students. And so the impetus for a week long course that could refresh and best prepare us for common problems we’ll face in intern year of residency arose.
The course has been interactive and fun, which is important, because senioritis is real, even for medical students. But surprisingly enough, most of the topics we cover are not what you’d expect. There is less of complex physiology, and more of the practical: what would you do if you received a call in the middle of the night and your patient complains of chest pain? The difficult answers are not usually complex diagnostic algorithms, but rather whether or not to call for help, i.e. escalate care.
When I’ve spoken with seasoned physicians, many of them have relayed the same phrase: “In intern year, you learn to tell whether a patient is sick or not.” I always thought that statement didn’t make sense; a 10 year old can tell whether someone is sick or not. But now I interpret that statement to mean that an intern learns which medical problems could lead to disastrous medical problems, and which of those conditions have an efficacious intervention. It’s a skill that incorporates more than a refined gut feeling but also a knowledge of pathophysiology and treatment. At least that’s what I’ve learned in intern boot camp. We’ll see about the real thing on June 24.
