Making the most of clinical week during MS2 and more ;)

[starstarie]

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So I'm an MS2 and we have a clinical week at my school a few times a year. Basically it's a week of I'm working at a family med clinic at seeing a lot of pretty young, healthy patients and a lot of psych. We are not formally graded.

There were a few things I was looking for advice on:

1. How can I make the most of this week? It seems that it is only there to kind of remind us of our end goal and all of that. However, I would really like to try to get a bit more out of it. Right now I would say my major weakness is that I am very apprehensive about doing a physical exam. I feel like the poor patients really do NOT want me to do an exam I don't know how to do anything and won't find anything abnormal on, just to have to have it repeated a second time. I don't think I touched a single patient today. Most of them really don't need/end up getting much of a PE anyway... I guess how can I set up some goals that will help me learn something/anything relevant?

2. One of my preceptors at school told me that it is good to try to work in EBM into the evaluations of patients. For example pre-test probabilities and so on. So for example if someone came in with possible strep throat, I could mention those criteria for strep that can estimate pre-test prob. However, I am not really sure how to execute this, and if it is actually something that is really done.

3. I have a good grasp on history taking, but I think everything seems like a jumbled mess. Is that normal? I don't feel like I have much order to things, which is frustrating and leading to me missing things. I am interested to know if other people kind of feel the same way about this. I could imagine it is just a normal transition phase because of the overwhelming change from our usual routine. If not, and it is just something I'm doing, does anyone have suggestions on how to make this a little more methodical so i don't miss things?

Thanks in advance!!

 

[Mr. Mojo Risin]

Ask your preceptor what they are comfortable letting you do. Maybe they can briefly explain to you their methods. Perhaps ask if you can go into the next room to get a history and physical, since you say you have trouble with that. I think if anything this would be a great opportunity for you to improve those skills through practice.