Walking down State Street this morning, undergrad overrun, I realized I’d better get in a few final thoughts about the summer months in Ann Arbor before we settle into fall.
One of the highlights of summer was having the flexibility to seek out more shadowing opportunities. Besides the obvious excitement that comes with seeing real cases, there is a more subtle delight in affirming that I genuinely love being with sick people and being in the hospital. At this stage in my training, I have no real (respons)abilities that contribute directly to patient care, yet I often come away feeling that both the patient and I benefitted from the interaction. I admit that I likely get the lion’s share of the joy, given that each time is new and exciting — I start to see some of the subtleties of what happens back in the call room, of who challenges whose authority, of how the system comes together. Then, of course, I get to actually see medicine applied, listen to real heart murmurs, and witness how patients respond to doctor’s advice.
Sometimes I simply observe, but other times I am involved in the visit, whether that means being part of the conversation in taking their health history or truly doing parts of the physical exam. While shadowing on the inpatient cardiology service, I got a sense of what it will be like to be an M3, from pre-rounding on your patient, to entering the vitals from overnight, to going on rounds and hearing each patient presented. A few weeks later, when I shadowed in the Psychiatric Emergency Room, I learned about some of the unique aspects of our separate psych evaluation area. Besides the patients themselves, I think what fascinated me most during this visit was learning about how it’s determined if and where to hospitalize psych patients. Finally, I went into the general outpatient medicine clinic in Taubman; it was here that I saw the greatest range of patients and complaints, from a young woman returning from India with gastrointestinal issues to an elderly man with concerns about recurrent headaches.
For the most part, patients seem to enjoy the presence of a student. I have yet to have a patient refuse to have me in the room and many of them actually appear relaxed and eager to talk to me. (Granted, it’s not as though I am requesting permission to do any procedure on them, but – in fact – the data indicates that patients are surprisingly willing to allow students to “practice” on them, under the careful supervision of an MD.) Getting things done in the hospital has a lot to do with the relationships, whether between a doctor and a patient, a nurse and an administrator or a student and a resident. Although I won’t begin clinical training for several more years, it’s motivating to start seeing more of what to expect.