The medical student’s baseline

They say that illness is “the great equalizer” as we are all destined to fall prey to something microbe-driven over the course of our lives.

however, seeing as medical students are fiercely competitive, and have been deceived to believe ourselves better than illness itself, (why else would we become doctors….to help people?) I thought I would share the other great equalizer…the standardized patient.

Most of you would prefer your doctor had some “hands-on” training prior to his/her assessment of your own illness yes? I imagine so…the better question is, upon whom should said doctor learn their craft?

“ain’t gonna be me” I can hear the masses crying – and let me stress now. You’re right. The bumbling, unsteady, nervous hands of a medical student are the last you would want to see coming through the door of your exam room.

Thankfully – a few brave souls have committed themselves to being scraped, pinched, poked and prodded by medical students learning the basics of the physical exam. We call them standardized patients. Ideally, they are the purest distillation of a patient that we might see, surly, uncomfortable, and annoyed at having taken time off work. When we turn our backs on them during an exam, they mark us down, when we fake a reflex test, they know, and when we speak to quietly, they gleefullly state “WHAT!?” to let our examiner (watching via CCTV in another room) know that we failed to confidently address the patient.

Now that you have met the standardized patient, let us meet the types of medical student her or she will be subduing:

The Gunner – Known for their ability to answer questions faster and more accurately than Ken Jennings, this medical student is the bane (batman!) of all us normal folk. They ask questions they know the answer to..despite the iPad clearly open to that very wikipedia page sitting in front of them. They springboard off of your failures on to greater heights…and the world cheers when they stumble. (sorry…just a lil’ cynical)

The stutterer – It’s unclear how this student made it through the interview process. They stutter incessantly, not because of a speech defect, but rather because they interrupt their every thought aloud with its answer while holding up the entire class with their question. Example:
“So Professor G, why is it that the patients exhibit splenic crises with Here…oh yes, because of the membrane deficiencies..and are those caus…yeah, oh y.y .that’s rig…..ankrin/spectr…is that with a y?”
This student get’s their answer by the end of class. The rest of us leave confused.

The Facebooker – SOMEHOW, this student has survived 7 years of higher education without ever having logged out of facebook, twitter, or TMZ, they saw Venus’ c-walk live, and were the first to inform us that Kim Kardashian is getting a divorce…and they STILL get better grades than you.

The drunk. – Yes. Medical students drink…likely more so than their free-willed counterparts. The amazing thing is their level of function while intoxicated. I once wrote about a student who broke down the cranial nerves while attempting to stumble up a stairwell.

The Diva – this may be a product of being at an institution with our demographic makeup, but the number of students here who are unafraid to make DEMANDS of professors is staggering. They speak their minds freely, and are sure to smack their lips loudly whenever they answer a question correctly in their minds. Incidentally – they are the most amazingly attractive humans I’ve ever seen.

The foreigner – This student for reasons unknown, has no interest in you, your class, or your education, their “fadda” said to “stoody de boooks” and that’s what they’ve come to do. Beware of this student, for they do not sleep, they do not eat, and they will not rest until you ar…sorry, got lost in the terminator reference. They’re pretty cool, if you can get over the inherent cultural differences that will exist between you and them.

So, the great equalizer.
Imagine if you will that on a bright tuesday afternoon, each of these students walked into their respective exam rooms, dressed in their [previously] white coats, and was faced with the patient I had. I’ll avoid all of those HIPPA – infringing descriptors and simply say she looked angry, with downturned lips, a scowl, and an unflinching gaze. I tried my usual cheery/suave and she cut through it like a scythe. At that moment I became the stutterer, and the drunk, making incoherent requests for the patient to raise her arms, do “the twist” and extend her legs.

When it came time to palpate her trochanteric bursa (a maneuver that requires the waist of the pants to be pulled down a good five inches, I froze. I know it’s hard to imagine a 24 y.o. male freezing up at the prospect of pulling any form of pants down, but in that moment, I was the African student, and this was my elder [read: matriarch]. I think I apologized three times before I exposed her hip, only to find that she’d chosen today to wear her tightest-fitting underwear, clothes that required me to confidently grab the elastic and pull. I won’t lie, I fudged the test, pressed convincingly around the upper buttock, and clearly stated, “no abnormalities present”

(did I mention that my evaluator was in the room because the CCTV was down?)

The best part. Every student mentioned above told me they had the same experience. I am REALLY not looking forward to this pelvic/rectal exam.

sincerely ,
the undeterred.

P.S. – we’re also graded down for the use of excessively complicated language with our patients.
I thought I was going to fail.
She looked at me quizzically when I asked her to “disrobe”

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