On Having Medical Students

The last few months of residency have been a blur. Second year has been as busy as ever and on top of looking after patients, I have medical students to look after now! After being the senior resident with junior residents and medical students, I’ve gained a new perspective on medical education.

It has been interesting supervising medical students. What a big difference a few years can make, as I compare myself to these new clerkship students. I was in their shoes not too long ago, in fact it was only three years ago! For the most part, I enjoy having medical students on the CTU team, even though they aren’t always that helpful. There’s also such a diversity in terms of knowledge, skills and communication skills amongst them. So I thought I would share some thoughts now that I’m finally on the “other side.”

Medical Students will Take up your Time

In general, medical students slow you down. Most of the time, they don’t know what’s going on and because of that they will ask a lot of questions. If it normally takes 15 minutes to see a patient, it will take new med students twice as long. At their stage everything is new. From taking good histories to performing physical exams you have to factor in their inexperience. Even final year elective students will require your guidance (or at least your signature). The sooner you factor this in, the better you can plan your days.

Medical Students Need Supervision

I probably didn’t receiving enough supervision as a medical student. I could have learned a lot more if someone had looked over more what I did clerkship. I could have saved myself a lot of time spent figuring things out on my own. At the same time, I try not to micromanage or do too many things for my medical students. Although I know it’s much faster for me to do their work, the whole point of clerkship is for them to learn. Currently, I let my medical students see patients and write notes on their own. Afterwards, I review with them their findings, proofread their notes and then we go back to see the patient together. I usually try to go over physical exam manuevres at this time and then I give them a chance to explain the medical plan to the patient. I think this way gives them a sense of patient ownership.

Medical Students have Different Strengths and Weaknesses

Despite having been in the same classes during preclinical, there is such a variability in knowledge, communication styles and work ethics amongst clerkship students. Some are very book smart and the majority have forgotten all their medical knowledge.It doesn’t take long to figure out who are the excellent students and who are the ones that need help. Similarly, it’s easy to spot the hardworking and lazy ones. Some you can trust and others you will have to supervise more closely.

Medical Students want to Learn

Above all, clerkship students are excited to learn. They’ve been waiting four years of undergrad and another two years of medical student for this moment. They are here to see and look after patients! Give them opportunites to learn at an appropriately level.I personally find their enthusiasm contagious. I enjoy having new learners on the team as it helps me look at topics I know in a new light. Teaching them medical knowledge makes each topic and concept clearer for me too, as I try to explain to them in the most basic terms. I also try to teach them non-medical things during the day such as tips and tricks for getting things done in the hospital or how to communicate with families and other disciplines. So far I have gotten a good response to my teaching.

As a senior resident, I think one of the most important things we can do is give specific and timely feedback our learners. Even though medical students will pick up most things by “doing” it, they need to know what they are doing is right or wrong. There is so much inconsistency in their teaching that they often don’t know what they are doing is wrong.If they have a medical concept wrong – the best time to correct them is as soon as possible. If they make a mistake or error in judgement (which they will do, double/triple check everything they do), correct them in private and remind them that you are there to help.

Medical Students Need Feedback

I’m sure my views of medical students will change as I work with more students at different stages of their training. I find students at the start of clerkship are more keen but lack knowledge. End of year students have knowledge and experience but can often be burnt out. Ways medical students can fight these effects is to read more during the beginning of the year and learn to find balance near the end.

Overall, I found teaching and supervising medical students an enjoyable experience. Perhaps there’s still some academia in me left despite my leaning towards community practice.