H & P's

[SilverScrubs]

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Just curious as to how and when you get to do them as a med student during your rotations where you're at. Do interns have dibs on them first, i.e. on IM rotations?

 

[MrBurns10]

Most rotations you'll get to do them ("get" quickly turns into "have to", as writing up H&Ps is quite painful). The intern or resident legally has to do one on every patient, but you'll do one on one or a few patients per call night. Usually, you'll get the first ones that come in or a particular interesting case.

 

[SilverScrubs]

Thing is there's no call night for us where I'm rotating and most of our admissions are coming in after hours. The interns when they remember call us during the day to do some but ...seriously I only got to do 2 this whole past month. Too many students and not enough admits I think. Sigh...

 

[futuredo32]

I did a lot of H&Ps during my IM rotations as well as during general surgery.

 

[EternalMD]

At my institution, interns/residents are supposed to do their own H&Ps and as students we do our own for each patient. It helps the intern if we're at the VA with computerized records since they tend to copy some of the information but otherwise, they still have to do it themselves

 

[Doctor Bagel]

Thing is there's no call night for us where I'm rotating and most of our admissions are coming in after hours. The interns when they remember call us during the day to do some but ...seriously I only got to do 2 this whole past month. Too many students and not enough admits I think. Sigh...

Hmm, weird. We only admit patients on call, so all the H&Ps come from call night. We're expected to work up 2 patients each long call and one patient each short call (that doesn't always happen because we have lectures and other stuff when we're on short call). We have to write a full H&P, and the intern does as well. Then the senior writes a shorter one. Here, the interns don't seem to pay a lot of attention to student H&Ps so we're really doing it for learning and not for the chart, which is a little unmotivating. We have to turn in 12 writeups on the IM rotation, including 4 H&Ps.

 

[Anka]

To be honest, it helps the intern, even if we have to do our own anyway. If I'm working with a good medical student, all I have to do is go over the important stuff with the patient, confirm any physical exam findings I'm going to base decision making on, etc. It's much faster, especially when dealing with patients who are hard to direct, or come with a 100 page chart. Depending on the student, even their plan is helpful -- I'm still learning, you're still learning. We both think of things the other person might have forgotten. On the other hand, a bad medical student is worse than useless, and I usually just try to make sure they're as involved as they need to be to meet their course requirements.

Anka

 

[MrBurns10]

Thing is there's no call night for us where I'm rotating and most of our admissions are coming in after hours. The interns when they remember call us during the day to do some but ...seriously I only got to do 2 this whole past month. Too many students and not enough admits I think. Sigh...

No call? Well, I'm guessing your team is on-call every 4th day or so? Maybe on those days, you just stick closer to the intern so that when they get paged about a new patient, you're right there. It might be a little bothersome for both of you, but H&Ps are good learning experiences (as much as I hated doing full write-ups, I really did learn a lot).

 

[ShyRem]

I have to turn in a full "academic" H&P every week on IM - these can quickly turn into very long write-ups on a complicated patient. For in-hospital consults they generally let me go in first to do the whole darn thing and then the resident goes in for 5 minutes or so and hits the highlights of my work. Some attendings want my H&P in the chart, some don't care. But the resident has to write a full H&P anyway - just if I get there first I can save them a ton of time (and they appreciate that).

 

[45408]

Hmm, weird. We only admit patients on call, so all the H&Ps come from call night. We're expected to work up 2 patients each long call and one patient each short call (that doesn't always happen because we have lectures and other stuff when we're on short call). We have to write a full H&P, and the intern does as well. Then the senior writes a shorter one. Here, the interns don't seem to pay a lot of attention to student H&Ps so we're really doing it for learning and not for the chart, which is a little unmotivating. We have to turn in 12 writeups on the IM rotation, including 4 H&Ps.

I keep saying this after your posts, but that's pretty similar to my experience for medicine.


When I was on trauma surgery, I did most of my H&Ps independently, because I carried the consult pager. Once I was finished (maybe half an hour), I'd start filling out the consult form and page my senior. The surgery H&Ps are obviously shorter and more to the point than the medicine ones though. When I was on medicine, it kind of varied. Sometimes I didn't come in until after the intern had all s/he needed, other times they would stand in while I asked my questions and then leave once they heard enough.

 

[anon-y-mouse]

"get to"?! hah! Trust me, they will MAKE you do H&P's. In medicine, they don't really count, but so many of my H&P's for other rotations have been incorporated as the 'only' h&p in the chart (obviously signed by the resident). I mean, either they're super lazy, or are flattering me because I can write a good one (or something). At any rate, it used to take me like 45 minutes - 1 hr to write one, but after writing so many, I can crank a good one out in 5-10 minutes. Trust me, if you go to a good medical school with a good teaching hospital, you will become very proficient with them.

 

[MSmentor018]

doesn't matter what rotation i am doing, dusk or dawn....if a new patient is on my attending's list....I do the H&P then they cosign it.

 

[Doctor Bagel]

"get to"?! hah! Trust me, they will MAKE you do H&P's. In medicine, they don't really count, but so many of my H&P's for other rotations have been incorporated as the 'only' h&p in the chart (obviously signed by the resident). I mean, either they're super lazy, or are flattering me because I can write a good one (or something). At any rate, it used to take me like 45 minutes - 1 hr to write one, but after writing so many, I can crank a good one out in 5-10 minutes. Trust me, if you go to a good medical school with a good teaching hospital, you will become very proficient with them.

Yeah, come to think of it, the H&Ps I wrote in OB for triage patients were the H&P in the charts. The same was true with my soap notes. In medicine, apparently everything has to be done again by the intern.