Now that we have rung in the new year, the countdown to graduation is on! In less than 6 months I will officially be able to add the title of “doctor” before my name. With my growing excitement also comes a pang of anxiety. With more freedom means more responsibility. This month I have been on my rural family medicine rotation which has been at a clinic in my hometown. As a 4th year medical student I have been granted more autonomy and I am able to pick which patients I see and do a history & physical and order all labs, imaging, and special tests how I see fit. It is the first time in the past 4 years that I truly feel like a doctor and believe that I am making a difference.
Being in an outpatient clinic is fast paced, and it feels that the days blur together as I am tasked with seeing patients every 15 to 20 minutes. I knock on the door and I enter, introducing and identifying myself as a medical student. Sometimes I am greeted with a smile, other times with confusion as I am not the face they expected to see coming into their exam room. Usually these patient’s brow furrow and begin to interject before I quickly reassure them that my attending physician will be in to see them afterwards. This is often enough to alleviate most of the concerned, but occasionally I encounter a patient who demands to be seen by an “actual doctor” or inform me they’ve already been “seen by the nurse”.
Can I blame them? Absolutely not.
It often takes weeks to secure an appointment with a doctor and nowadays it feels like the provider spends less than 5 minutes in the room with you. Would I want to “waste” my precious appointment time slot talking to a student… no, probably not. But what if I told you being seen by a medical student actually improves the quality of care you receive at your doctors office?
Hear me out.
What a medical student lacks in experience they make up for in resourcefulness. After seeing a patient, it is expected that we will understand the medications they are on, the labs they need and the indications for both. We must be able to justify why we want to order imaging or why we want to diagnose a certain condition. If we do not understand any of these aspects of care we are responsible for looking up this information on a medical platform backed by the most up to date research and industry standards. Aside from studying between patients, there are seemingly endless numbers of tests to take in order to move forward in medicine. Medical students must take three board exams between 3rd year of medical school and our 1st year of residency, to ensure that we are up to snuff on our core medical knowledge. Throughout medical school and residency we are expected to do continuing education. We participate in research, we hold memberships for the associations of our various specialty interests and attend annual conferences to discuss pertinent changes in our given fields. The learning never stops. Being seen by a medical student ensures that you have someone on your team who is current and up to date on medical knowledge.
Allowing a medical student to see you before your physician guarantees you have two sets of eyes on you at your appointment. Medical students are unable to operate independently which means every lab test or suggestion written in the plan has to be approved by an attending physician. Not only do you have two people looking at your suspicious mole, or listening to your child’s lungs you have two people listening to your symptoms and brainstorming treatment options. Outside of the exam room, the attending physician will use your x-ray as a teaching tool, and will spend 10x the amount of time he or she would’ve spent looking at your imaging alone making sure each line and shadow has been identified by the student. When discussing your medication options, a medical student has the benefit of working with many physicians at the same time and can offer recommendations of alternate treatment options or new developments that your physician may not be as familiar with.
Another benefit of seeing a medical student is that they are not held to the same time constraints as a physician. I’ve been allowed to sit and discuss plant based recipes with a patient who wanted to try some vegetarian meals for her meat-and-potatoes family. I alleviated one man’s concerns when he questioned how his doctor would perform a lithotripsy. Last week when a patient broke down in tears after 4 years of stress caring for her ailing mother I was able to sit with her and listen to her story. Often times people seek medical attention because they need some one to talk to, even if it’s for 15 minutes a medical student has the ability to be that confidant that a patient needs.
Lastly allowing a medical student to assist with your medical care is your one opportunity to impact the future of medicine. Not only do you serve as a real-life example of the textbook cases we have read about for 4 years, but you now have the opportunity to give a future physician feedback. If you wish doctors explained things more in depth, made better eye contact, or considered non-pharmacological treatment options now is your time to say so! As a medical student we are still impressionable. If I press on your belly too hard or hurt your ear while looking through my otoscope, I’d rather know now than wait 20 years to have a patient build up the courage to tell me they don’t like something I do. Most medical students chose this career because they wanted to help someone, so help us help you.