Geoffrey Yong, fourth year medical student at Newcastle University, reflects on his clinical years at medical school and how to get the most out of them.
I still remember vividly listening to a heart murmur for the first time. I also recall the nerve-racking moment when I was asked to assist a surgeon in performing a Caesarean section. These are just two of the countless memorable moments I had during the first half of my first clinical year alone.
Medical students usually find their clinical years an exciting part of their time in medical school, and learn invaluable lessons along the way. I certainly have, and I want to share some of these with you in the hope that it will help you make the most of your own clinical years.
Many medical students are initially concerned about getting in the way of busy staff members when they first enter the hospital environment. Because of this, many find themselves loitering around the ward corridors twiddling their thumbs.
It’s completely normal to feel like this at the start. However, you will soon find that healthcare workers are in fact very approachable, helpful and passionate about teaching – so don’t be afraid to ask. It’s always useful to prepare a set of learning objectives beforehand, so that you know what to ask for. This might include asking for patients who would be happy to have you examine them or take their history; or even asking a doctor to teach a particular subject that you are finding difficult. Always take the initiative.
Focus on progress
As an avid fan of the National Basketball Association, I’ve come to realise that professional basketball players are rarely satisfied with their current performance and are always striving to improve. This principle is very relevant to medical students. I try to reflect on my current performance on a daily basis, and to constantly think of ways in which I can improve. Think about your clinical reasoning skills, communication and professionalism, and always follow up your reflections with an action plan.
Another way to improve your performance is by constantly and actively requesting feedback. Ask the doctors you shadow if they can observe you taking a history or examining a patient, and then ask what they think you could do better next time. By doing this, I’ve been taught things that I could never have learned from just reading textbooks.
Interact with patients
Your clinical years are exciting – and valuable – because you finally get to see real patients. However, it’s not uncommon to have genuine concerns about this early on. Many students worry about communicating effectively with patients, or about harming someone unintentionally. I’ve found that the best way to tackle these concerns is by facing them head on, with more patient interaction to help build your confidence.
When you practice taking histories, try to develop a holistic approach. Explore the patient’s ideas, concerns and expectations. If appropriate, also ask about the social and psychological impact caused by their condition. If patients share their stories with you, take the time to listen and always express empathy. Patients really do appreciate it when they feel that they are treated as a person and not just as a case to learn from.
Besides that, always make sure that patients have given their consent, and are aware that you are a medical student before you do anything. Abide by the rules set by your medical school, and always act within your competence.
Interact with healthcare professionals
During your clinical years, you will have the opportunity to work closely with other healthcare professionals. They play a huge role in helping you learn as a medical student, so it is important to develop a good rapport with them.
Most important is learning to give and take. Although healthcare professionals are happy to teach without expecting anything in return, you can always offer something useful, like helping a junior doctor clerk new patients so that they can catch up with their paper work. After that, present the case back to them and ask for their feedback. Not only does this aid your learning, it also allows you to ease someone else’s workload. There are always ways you can contribute.
It is easy to be overwhelmed by heavy workloads and long working hours during your clinical years, and forget how much you actually get to do as a medical student. Remember, you will have the privilege of seeing, learning and experiencing things you never thought a student could do. Make sure you treasure every opportunity when your time comes.