At my medical school we start “rotations” a little early – about a month into our first year instead of in the third year as is traditional. They call this “rotation” a clinical apprenticeship, and it is usually done at a physician’s office. Of course, it goes without saying that these apprenticeships cannot be nearly as in depth or intense as the usual third year rotation considering our extremely inadequate medical knowledge and clinical expertise. This however, did not prevent my inexperienced first-year-self from being terrified at the prospect of ever having to interact with a real patient.
I was assigned to work with a cardiologist who had a small practice a few miles away from my school. That first day of apprenticeship was probably one of the most dreaded days of my life. I would have honestly rather taken biochem exams for a week straight than go into that office.
It was explained to us that our duties would consist of just basic interviewing (getting a chief complaint, age, medications, history, etc) and whatever physical exams we felt comfortable doing (pulse, bp, eye exam, etc.). This seems rather simple at first, but I couldn’t help but stress about all the multitude of tiny things that could go awry. How should I introduce myself to the doctor? What should I do if she asks me a question and I don’t know the answer? What would I say if a patient didn’t want me to interview them? What would happen if I misheard something and documented it wrong? What if the patient got insulted by a question I asked them? So many things could go wrong!
But, as these things usually go, the actual experience wasn’t nearly as bad as my unnecessarily overactive imagination made it out to be. I walked into the office, and my preceptor was nothing but nice and extremely understanding of my lack of clinical knowledge. None of the patients ever questioned my ability to interview or examine them (though that probably had a lot more to do with my fancy new white coat than their actual faith in my abilities). Any time there was a question I couldn’t answer or a topic I didn’t know enough about there was a technician, nurse, PA, third year medical student, resident, or attending available to answer.
I’ve learned that there are many things to fear and many things that can go wrong in the world of medicine. However, there are always people that understand and can help. Medicine is intrinsically an interactive and cooperative field – and this makes all the hard parts, just a little less so.