Bridging the gap

How is it going to feel after you have stuck your nose in books 24/7 for 2 years and then jump in to a hospital room and start diagnosing a patient?

As a breakdown, medical school is 4 years. The first 2 years are filled with lectures and textbook material. The last 2 years are rotations. Your 3^rd year is consisted of mandatory rotations: surgery, family medicine, medicine, psych, obgyn, and pediatrics. Your 4^th year is filled with elective rotations, audition rotations, and applying for residency.

One thing that has been brought to light by a lot of institutions is answering this question: Are student’s prepared for 3^rd year rotations? This is when students are required to put everything they have learned in 2 years in to practice (and that’s A LOT of information). Students will be required to answer all of the doctor’s questions quickly and correctly (constantly being tested on the spot). At the same time, they are to remain calm and collected enough to have good bed side manner towards the patient.

Funny story: my 16 year old sister-in-law was in ICU at a children’s hospital this past summer. This happened to be a teaching hospital, where she was bothered every hour, asked the same questions by rounds of medical students, residents, nurses, and doctors throughout the entire day. One medical student was asked to check the discoloration of her finger nails. The student politely asked to look at her hands, told her what he was looking for, and studies her finger nails for quite some time. Writes something down and then stares at them again. My sister-in-law looks up at her mom and they are in disbelief that this student cannot figure out that she has on fake nails! Whether he was extremely nervous or he never had a girlfriend with fake nails before (or any girlfriend for that matter – just kidding!), the family got a good laugh from it all.

Anyways, institutions are trying to better bridge the gap between 1^st and 2^nd year to 3^rd year. Some faculty/doctors have a hard time providing an accurate and consistent curriculum for the students for multiple reasons:

1.      Medicine isn’t a field where every day you see the same things. Students are only able to learn from whatever patients came in that day. It is possible that some students receive a variety of cases and can learn much more, where some might get bored with the routine cases.

2.      Every institution is different. A teaching hospital will get a variety of students from different colleges. With this being said, each college teaches their students differently. Some might have more/better clinical skills than others. Therefore, the doctor teaching might have to ‘dummy down’ to the basics and bring one student up to speed or choose to move on his or her own pace.

3.      Every doctor teaches differently. There is not necessarily a uniform curriculum (due to reasons 1 and 2) the doctor abides by. Some doctors allow their students to get more hands on experience than others. Whoever the student is assigned to can make or break the experience for them. This leaves those ‘Type A students’ upset and dissatisfied that someone else was able to do more than them.

On top of the curriculum, faculty feels that students are just not as prepared (or too timid and uncomfortable) when entering their 3^rd year. Here is an article that might better describe the gap: MedicalEducation as a Process Management Problem

This school notices this gap and has already implemented programs to build bridges and better prepare our students for their first career exposure in 3^rd year. This year was the first year that they introduced a program called “The White Coat Project.” This program gives 1^st years an opportunity to “job shadow” (a term for those business majors out there!) for a few hours about once every few weeks. It is an opportunity for them to basically shadow a doctor of a certain specialty without the stressful environment that 3^rd year brings. Students have been enjoying this program because it serves as a reminder as to why they are studying so hard, will give them a better glimpse of what to expect, and calm the nerves come 3^rd year.

Funny story: a student came in yesterday morning asking me to borrow a pen. I gave him one without a second thought. A few hours later after he was done studying, he generously gave my pen back. But when he handed it to me, he was only touching the ends of the pen with his fingertips and says “here, let me rub some hand-sanitizer on it because I have been sucking on it all day.” SUCKING ON IT??? First of all, who says that? Biting yes, sucking no! Second, I understand people bite on their pens, but don’t actually admit it when you are handing it back to me. In this case, ignorance would have been a bliss for me. Anyways, he holds the pen ever so gently, uses my hand-sanitizer on my desk, and douses it. Not one squirt, but two or three for just a small pen – seriously!? My pen (after being ‘sucked on’) is now dripping with hand-sanitizer. As he is doing this, I repeatedly tell him “No really, you can keep it!!” and he insists on giving it back to me. He notices I refuse to reach out and grab my wet pen so he walks over to the side of my desk (still carefully holding the ends of the pen with his fingertips) and lays it in my drawer on top of all my other pens. Thanks dude!! I ended up throwing my pen away.
One of the services my office offers, is mock interviews. I will definitely be emailing this kid and saying the he NEEDS to come in for a mock interview and work on his social skills. Rule number one on your interview for residency: do NOT borrow their pens! Ha!