Clinical experiences in MS1

[RustedKOD]

I was wondering what everyone else is doing during their first year in a clinical aspect.

At our school, we have already learned to write SOAP notes, suturing, surgical knot tying, doing a essential parts of an H&P, female pelvic exams, and basic Rx writing...

What about you?

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[ChiDO]

Learned most of that during 2nd year. As much as all that stuff is "cooler" then studying, I'd rather have that afternoon every week as dedicated study time (hello step 1!) or to catch up on life then play doctor or play with mannequins (sp?).

 

[ChubbyChaser]

We learn the basics of all the exams the first year (Eye, cardio, neuro, etc.)...then second year they tie pathology into it.

 

[deuce924]

Our 1st year, we did Intubation, Tracheotomy, Lumbar Puncture, Sutures, Basic H&P, Physical Exam, C-Spine, EKG's and BLS. I am sure I am leaving something out but I that's what I remember doing.

 

[NTF]

For us:

1)Basics of history taking (CC/HPI, PMHx, Family Hx, Social Hx)
2)Basics of physical exam (vitals, cardio, resp, gi, breast/prostate exam)
3)Shadowing

Zero procedures.

 

[kl323]

Our 1st year, we did Intubation, Tracheotomy, Lumbar Puncture, Sutures, Basic H&P, Physical Exam, C-Spine, EKG's and BLS. I am sure I am leaving something out but I that's what I remember doing.

Wait...on real patients or cadavers?
Hard to imagine MS1s doing intubation, trach, LP, and sutures on real live patients...

I did the first two on cadavers.

 

[deuce924]

Wait...on real patients or cadavers?
Hard to imagine MS1s doing intubation, trach, LP, and sutures on real live patients...

I did the first two on cadavers.

Mostly on cadavers. Intubations, Trachs, LP's, and Sutures were on cadavers. Basic H&P, Physical Exam, C-Spine, and EKG's were on classmates.

 

[rockydoc]

For us:

1)Basics of history taking (CC/HPI, PMHx, Family Hx, Social Hx)
2)Basics of physical exam (vitals, cardio, resp, gi, breast/prostate exam)
3)Shadowing

Zero procedures.

same here...plus the occasional, just for fun, suture session type of stuff tied in with a surgery interest group or something

Like someone said above I kinda feel like all of that type of stuff is just "playing doctor" at this point and it's much more relevant to study. We will have plenty of time for all that "see one, do one, teach one" stuff later on.

 

[dnslay]

THEY LET US SEPARATE TWINS FTW!

 

[OpalOnyx]

It's nice to do some doctoring during the 1st two years to remind us of why we are sitting in the library for hours on end... but personally, I would find it tough to focus on step 1 in a curriculum that has *too much* volunteering/shadowing in the first two years. A little is good and neccessary. But the first two years are meant to be skewed towards studying anyway.

 

[thepoopologist]

I did a heart transplant. Piece of cake.

 

[unsung]

same here...plus the occasional, just for fun, suture session type of stuff tied in with a surgery interest group or something

Like someone said above I kinda feel like all of that type of stuff is just "playing doctor" at this point and it's much more relevant to study. We will have plenty of time for all that "see one, do one, teach one" stuff later on.

I know, I don't like "playing doctor."

Especially when it = taking away my free afternoons to study. If we didn't have these play times or the inane labs (not all labs are inane, but some definitely are!)... hey, I could actually be caught up each day and have some free time, how about that!

It's like med school has figured out how to devise a schedule that JUST manages to keep me perpetually on my toes and busy. If they took out some of the fluff, it would actually be a quite manageable workload.

 

[DeadCactus]

Main emphasis for MS1s here are history and physical skills. Some chances for procedure type skills as part of interest group activities or demonstrations during anatomy.

I feel like it's all stuff we do more because it helps recruit pre-meds than anything truly useful to a medical student. I honestly wish they would just hand me a syllabus and a test schedule and leave me alone to sit in the library. I can find opportunities for clinical exposure on my own...

 

[OpalOnyx]

I feel like it's all stuff we do more because it helps recruit pre-meds than anything truly useful to a medical student.

yea for that little phrase "early clinical exposure" on their website or AAMC handbook

 

[illixir]

In first year, we did history-taking, and gradually reinforced components of the physical exam as they came up in our curriculum(we're systems-based), we then also just had a clinical immersion week every block(6 blocks in 2 yr) that was on the hospital floor in those specialties and practicing those components with no new school material. In either first or second year, we then had to do a CPCP which is going and working with an outpatient physician and just taking histories and targeted physicals on their patients before they do and then getting feedback and seeing what his treatment plan is. In second year, we went into the hospital and did 3-5 full history and physicals on patients there with full soap notes. Then we got the OSCE's to make sure we can do it all right. It's been alot of stuff at my school I think, but it's been good. And maybe needed since for some we do 2nd year starting clinical rotations in 4 weeks from now.

 

[airplanes]

Main emphasis for MS1s here are history and physical skills. Some chances for procedure type skills as part of interest group activities or demonstrations during anatomy.

I feel like it's all stuff we do more because it helps recruit pre-meds than anything truly useful to a medical student. I honestly wish they would just hand me a syllabus and a test schedule and leave me alone to sit in the library. I can find opportunities for clinical exposure on my own...

We do an afternoon a week of learning history and exam skills, then another afternoon matched with a practicing preceptor. We get matched according to interests and last term i was in the ED taking histories, doing exams, reporting back to the preceptor and generally learning what medicine is all about. This term I'm in peds, it's been a lot of fun. My preceptors usually throw me in there and I figure out what I can on my own, then I report back and they give me some pointers and go over some teaching points. I've seen some pretty cool cases and it's been great to get a clinical and patient oriented component because its so easy to get dragged down in the basic science.

Yes, we don't know much, but we don't do any harm, and it's been a great learning experience. Plus we get exposure to fields we are interested in with volunteer preceptors who actually care and want to teach. Other classmates have matched with ortho, radiation oncology, derm, trauma surg, etc. seeing patients, scrubbing into surgeries, etc. We do one year of elective preceptorships, then a year matched with a primary care physician. It's honestly been one of the best parts of 1st year, not just something to "entice premeds" with. We've also been doing group osce's and osces.

 

[SouthernSurgeon]

Mostly on cadavers. Intubations, Trachs, LP's, and Sutures were on cadavers.

Then they are even more useless for the M1. An intubation on a formaldehyde-d cadaver is nothing like on a real person.

If you aren't learning the procedure from someone within the field (i.e. not your anatomy profs), and aren't getting to practice on a patient or a quality model (and even those are a far cry from the real thing), the exercise really is just "playing doctor"

 

[phospho]

I honestly wish they would just hand me a syllabus and a test schedule and leave me alone to sit in the library. I can find opportunities for clinical exposure on my own...

completely agree...

 

[KeyzerSoze]

Then they are even more useless for the M1. An intubation on a formaldehyde-d cadaver is nothing like on a real person.

If you aren't learning the procedure from someone within the field (i.e. not your anatomy profs), and aren't getting to practice on a patient or a quality model (and even those are a far cry from the real thing), the exercise really is just "playing doctor"

Intubations may be useless, but LP's have got to be even worse. I don't think the cadavers even have any CSF left in them.

 

[thechad]

LP's have got to be even worse. I don't think the cadavers even have any CSF left in them.

Not to mention getting a stiff dead body into the fetal position...

 

[SouthernSurgeon]

Intubations may be useless, but LP's have got to be even worse. I don't think the cadavers even have any CSF left in them.

They had us do that one in our anatomy class...but it wasn't under the pretense of teaching clinical or procedural skills...it was just a way to make us memorize the layers of the back (which I ended up having on step 1, so I'm okay with it).

 

[pingouin]

This is an interesting thread- my small group was just pondering the other day what clinical exposures other people had in the first two years.

As M1s, we spent a block on learning to do histories, a block on physical exam, and a block on histories in special situations (substance abuse, domestic violence, child abuse). All of those involve some SP experiences. For 3 of our 4 blocks, we were assigned to a different preceptor and had to attend 3 4-hour clinics in that block. One block was with primary care, one with a specialty, and the last was whatever they assigned you to. Precepting varied from "just got to watch" to "did the entire history and reported to the attending" to "worked in urology clinic and got my mandatory DRE experience out of the way. poor old dude- had no clue when he woke up in the morning..".

M2 year, that precepting is available again for the last three blocks, but it's optional. However, student picks the specialties this time around. We are also split into groups of 4 and assigned 2 Medicine preceptors to help us work on our H&Ps. By the time we finish our May exams, we'll have performed 6 full H&Ps complete with presentation to attending and full write-up.

Plus, we have a student run free clinic for uninsured people in the community that runs once a week. M1s/M2s do the interviewing and assist M3s/M4s with the PE, with residents and attendings overseeing. Pretty cool.

 

[KeyzerSoze]

THEY LET US SEPARATE TWINS FTW!

Not very difficult unless they're conjoined.

 

[dnslay]

They were really whiny!

Not very difficult unless they're conjoined.