Why don't we ask the medical student?

At my current elective, they have rounds held by the residents every monday, where they present cases to the doctors to illustrate important clinical points, as a source of 'refresher'. One pattern that I've noticed is that at each of these talks, they always decide to ask the 'medical students'. Of course, since there's only one medical student in the clinics right now, guess who has to answer the questions? You guessed it...me!

Last week, I managed to wiggle my way out of the question by pretending to have not heard the resident until too late, but the other two times, the residents were kind enough to warn me in advance that they would pick on me. Not that it helped me too much. "Oh, by the way, you should know your dermatology", or "do you remember how to interpret ECGs?" Like I'm going to have time in the next 5 minutes to look up the relevant information to refresh my memory.

Both of these times, I've lucked out and pulled out decent responses, partly because my studying for the comprehensive exam seems to have paid off. But for the dermatology question, I was seriously pulling things out of my ass: "um, that lesion looks like it is macular in appearance, with regular borders, and oh yah, maybe it's erythematous too, with some blood vessels invading it!" :P

At least with the ECG question, the resident gave me a hint: there's something wrong with the QT interval. So it was pretty obvious (to anyone who's had some cardiology training) that this was going to be a prolonged QT interval case, which is then bad because it can lead to a heart arrhythmia known as a Torsades de Pointes. So other than a bit of difficulty calculating the heart rate (apparently my mental math goes down the drain when I'm under pressure!), it didn't go too bad.

So even though these weren't that bad, I'm here thinking, "sure, pick on the med student, will you? Pick on the guy with the least knowledge out of everybody!" I'm told the residents were being nice warning me in advance, but if they REALLY were nice, they'd let me enjoy my free food in peace.

(fyi, it really wasn't bad, but I just feel in a complaining sort of mood today, and I needed something to write about in my blog too)

Too much trust?

Did my first history and physical today without ANY supervision. I reported some findings to the doctor I was shadowing, and he seemed to believe me without checking them out himself. I either think that he trusts me too much (if I were in his situation, I wouldn't believe any findings a second year medical student reported!), or he felt that the patient was so well that my examination was irrelevant. I'm thinking (and hoping) it was the latter, since I was also given the responsibility of dictating the progress report. Not the best experience in the world, since I couldn't figure out how to re-record over mistakes that I made for the longest time, but at least I won't be completely incompetent when I have to do that when I'm on the wards!

...it only took two weeks!

Yes, this post is a little late in the evening, but that's because I was about to go to bed, and then I saw my friend who's visiting Africa online, so while I'm chatting with her, I decided to write this up.

For the past two weeks, I've been doing an elective in Medical Genetics, which hasn't exactly been the most exciting experience. Not that it's been bad; I've seen a wide range of patients that I'll probably never see again (and apparently some interesting neurology cases, according to the Neuro resident who was there too). The problem, however, is that since they see mostly kids, I'm not allowed to do a lot of the examinations due to my lack of experience.

So these last couple of weeks, all I've been doing is observing mainly, and getting the occasional bone thrown to me. "Chris, you can measure that baby's head!" or "listen to the heart!" Finally, on the very last day of my elective, having even skipped the floor picnic, on the last patient for this elective, one of the preceptors that I was following let me do something more 'invasive'. That's right: not only did I get to listen to the baby's heart, but I felt his hepatosplenomegaly (enlarged liver and spleen)! It ONLY took two weeks, but I finally examined my first real patient. Let's hope I'll see much more during my upcoming elective. :P