MD & DO M2 having "inpatient" anxiety

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Lifeblood_20

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Started M2 year last week, and my school requires second-years to start doing more clinical practices throughout the year. Namely, going into the hospital every few weeks to interview and examine a patient (under the mentorship of a senior student or attending). I just did my first one today and I felt so anxious and nervous throughout. The patient was so kind and understanding, but I felt guilty that I am basically taking up their energy to talk to me (and go through the entire physical exam redundantly) for the sole purpose of my education while providing no value to them. We connected well and at the end of it they even said they believe I will be a great doctor but I still felt like I had a knot in my stomach. Wondering if this is normal or if I am actually not fit to become a clinician in this inpatient setting.

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Started M2 year last week, and my school requires second-years to start doing more clinical practices throughout the year. Namely, going into the hospital every few weeks to interview and examine a patient (under the mentorship of a senior student or attending). I just did my first one today and I felt so anxious and nervous throughout. The patient was so kind and understanding, but I felt guilty that I am basically taking up their energy to talk to me (and go through the entire physical exam redundantly) for the sole purpose of my education while providing no value to them. We connected well and at the end of it they even said they believe I will be a great doctor but I still felt like I had a knot in my stomach. Wondering if this is normal or if I am actually not fit to become a clinician in this inpatient setting.
You are doomed.


You are fine. You'll laugh about this a year from now.
 
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I also felt nervous when I first started seeing patients. Adaptation takes time. It gets easier once you start rotations and you see so many patients. I'm a late third year now and I'm so used to seeing patients at this point, that it's automatic how I'll get through a visit. Just have a structure to your visits. Introduce yourself, ask them what they're here for, take a history as usual, etc.
 
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Totally normal. And you definitely belong in there seeing patients. And you absolutely do provide value to them. Not only to students sometimes ask questions and discover things missed by others, but just having the patient summarize and recount their story helps them remember key points. It’s one of the reasons that attendings often hear a very different story - the student or resident already went through things so it’s all fresh and they’ve also had a minute to remember the stuff they had forgotten.

But there’s also the fact you’re in a teaching hospital and that’s just part of the arrangement. Patients who don’t want to talk to a student will often self select away to private hospitals. These patients know the deal plus I’m sure you asked them if they would be willing to talk to you and they said yes. They have the option to decline to talk to a student - happens sometimes and nearly always the high maintenance ones you don’t want to get stuck with anyhow. They’ll be waiting for you on the other end of training!
 
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You are learning something new and trying something for the first time, and taking your first step out of the books and into the "real world" of patient care. Of course it's normal to be anxious! I just finished residency and sometimes I still get a little nervous meeting new patients for the first time or having certain conversations with patients. But, it does get much better!

Also, a lot of patients are excited to have medical students and other learners involved in their care. I promise you the patients doing these sorts of things with students are picked especially by your residents/attendings because they seem like the kind of person who would enjoy it. I often tell patients "thank you for teaching me!" after they allow me to observe an interesting procedure or exam finding or hear a little about a unique condition they have - honestly I think lots of folks like feeling like they had a chance to help someone become a better doctor. Medical students are also often one person on the team with the most time to listen to and educate the patient, which patients really appreciate as well. Absolutely, the patient is doing you a favor by chatting with you, but know that you also have something to contribute!
 
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Being social with strangers is not something most people are naturally good at. You probably haven't had to develop this skill until now. It gets much easier with time because you're literally forced to do it to be a physician or any healthcare provider.
 
The patient was so kind and understanding, but I felt guilty that I am basically taking up their energy to talk to me (and go through the entire physical exam redundantly) for the sole purpose of my education while providing no value to them.
I'm not sure how it is at your institution, but at our hospital us residents usually ask the patients if they agree to be examined and interviewed by students. The ones that agree are usually happy about being able to help students. Also, many patients are bored and have nothing else todo, so it sometimes helps them to have this contact.

I wouldn't worry too much about it
 
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I'm not sure how it is at your institution, but at our hospital us residents usually ask the patients if they agree to be examined and interviewed by students. The ones that agree are usually happy about being able to help students. Also, many patients are bored and have nothing else todo, so it sometimes helps them to have this contact.

I wouldn't worry too much about it
Everyone feels nervous as an M1/M2. You'll get over it quickly once you start M3. We only send M1/M2s to the patients who are agreeable and seem to enjoy socializing with the clinicians. We don't send the M1/M2s to the patients who are too cantankerous/altered/uncomfortable.
 
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IMO don't take your lack of knowledge too seriously as a med student, or even an intern, most/all of the important decisions are going to be run through your senior and you are expected to know nothing. Take it in stride and keep a running list to look up anything you don't know. The anxiety will wear off eventually!
 
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This is normal. A lot of the time as a medical student you feel in the way or that your exam is causing unnecessary stress.

Just relax, do what you can, and know when to back off. Maybe don't test the gait of a fall risk. You will get better at it in third year. Just remember OLDCARTS and be systematic.

You need to learn this stuff so you're not a clown as a resident.
 
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