Meaning of "early clinical experience"

[doremi2010]

For schools that say they have "early clinical experience" for example during the M1 and M2 years, what exactly does that mean? I've gone on a few interviews now, and feel like everything is running together and am more confused than ever.

Some schools I've gone to have allowed first years to actually work with real patients, like doing a pelvic exam. Other schools have simulators or actors as patients and students learn to interview, do exams, etc. So my question is, do the majority of schools have at least simulators or actors for M1 and M2 students to practice their clinical skills before year 3? Does it make a difference if schools allow students to work with real patients early on (especially if they haven't learned all the basic sciences yet)? I mean, all students learn clinical stuff during years 3 and 4, so it shouldn't make that much of a difference? But then, I've also heard some schools not really allowing med students to have much hands on experience like writing notes or willing to teach or have students around during the last 2 years.

Any help would be appreciated. Thanks!!

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[drizzt3117]

there are major differences in how schools allow students to work with patients during M1/M2. The extreme examples, of course, are schools with 12-18 month curricula. In any case, the more patient experience you have during the basic science years, the easier the transition to the clinical years will be.

For schools that say they have "early clinical experience" for example during the M1 and M2 years, what exactly does that mean? I've gone on a few interviews now, and feel like everything is running together and am more confused than ever.

Some schools I've gone to have allowed first years to actually work with real patients, like doing a pelvic exam. Other schools have simulators or actors as patients and students learn to interview, do exams, etc. So my question is, do the majority of schools have at least simulators or actors for M1 and M2 students to practice their clinical skills before year 3? Does it make a difference if schools allow students to work with real patients early on (especially if they haven't learned all the basic sciences yet)? I mean, all students learn clinical stuff during years 3 and 4, so it shouldn't make that much of a difference? But then, I've also heard some schools not really allowing med students to have much hands on experience like writing notes or willing to teach or have students around during the last 2 years.

Any help would be appreciated. Thanks!!

 

[NickNaylor]

It seems like most of it is pretty superficial at the schools I've been to. I wouldn't use it as a deciding factor unless the curriculum is fundamentally different (i.e., the clinical years start earlier than the traditional 3rd year).

 

[seelee]

Early clinical experience usually means some form of clinical training during the first two years. That may be as little as a "clinical skills" lecture where you learn to do a full H & P, to working with actual patients in a clinic or hospital. It is a good thing to ask the students at the school where you are interviewing.

Some schools talk about getting clinical experience as soon as the first week or two. This makes pre-meds squeal, but please remember that most clinical experience in your first year is pretty much irrelevant because you haven't really learned anything yet.

It is common to say that having the experience early makes the third year transition easier. Maybe it does, but I would like to see some data on it.

 

[drizzt3117]

We spend 16 days in M1/M2 in the wards/clinic, using electronic medical records, interviewing/examining patients, and writing notes. I don't think there's a scientific way to quantify the effects, but it was a pretty smooth transition into 3rd year for most of us, at least in terms of the nuts and bolts of doing things. In a lot of ways, that's what takes the longest time to learn.

Early clinical experience usually means some form of clinical training during the first two years. That may be as little as a "clinical skills" lecture where you learn to do a full H & P, to working with actual patients in a clinic or hospital. It is a good thing to ask the students at the school where you are interviewing.

Some schools talk about getting clinical experience as soon as the first week or two. This makes pre-meds squeal, but please remember that most clinical experience in your first year is pretty much irrelevant because you haven't really learned anything yet.

It is common to say that having the experience early makes the third year transition easier. Maybe it does, but I would like to see some data on it.

 

[ThaliaNox]

I think most schools have some kind of integrated clinical experience. My school, for example, has quite a few experiences where students interact with real or standardized patients to learn how to interview, take histories and practice physical exams. My favorite so far was going to the newborn nursery at the hospital to learn how to do newborn exams on real newborns.

We also had toddlers come in to learn how to do exams on them, and real non-actor teenagers to practice interviews about adolescent concerns. We also have some required "shadowing" experiences where the doctor usually sends us in to interview the patient before the doctor talks to them, and we practice presenting patients. This is on top of all of the experiences with standardized patients for interviewing and physical exams.

Another fun experience is that our school pairs us with a chonically ill patient for the first two years and we visit them in their homes every couple of months to talk about their chronic illness and how it affects them and their family.

 

[ucsfstudents]

The school teaches you how to take a medical history from a patient, and how to perform a general physical exam, and then you go interview and examine patients in the hospital and in the outpatient setting. In some schools, you will see patients starting the second week of medical school.

 

[organdonor]

Early clinical experience usually means some form of clinical training during the first two years. That may be as little as a "clinical skills" lecture where you learn to do a full H & P, to working with actual patients in a clinic or hospital. It is a good thing to ask the students at the school where you are interviewing.

Some schools talk about getting clinical experience as soon as the first week or two. This makes pre-meds squeal, but please remember that most clinical experience in your first year is pretty much irrelevant because you haven't really learned anything yet.

It is common to say that having the experience early makes the third year transition easier. Maybe it does, but I would like to see some data on it.

I second this guy. At my school we've already seen patients (I'm a first year) but it is all really superficial stuff. We take a history and next year we will be able to do a physical exam. Woop de doo. It would be exactly the same if they just told us how to do it and we practiced it on each other.

EDIT**
Or maybe I'm just biased about seeing "real patients" because I've got about a bajillion hours as a CNA in a hospital.
***

I wouldn't say our school makes a big selling point out of early patient care experience, but I guess we are getting some. They don't let us do much 1st or second year, because there are 3rd years, 4th years, interns, residents, fellows, or attendings to do that. We don't really know much yet. A second year med students isn't a lot more useful than a boy scout. But they can tell you all about complement or mitochondria.

If you really want truly meaningful patient care experience, pick a school that has a strong medical mission program. Sure when you are at a major academic center with CNA's, MA's, PT's, RN's, 3rd years, 4th years, interns, residents, fellows, and attendings they won't let you do anything. But in Africa when it's either you or the medicine man three villages over you get to do alot more. I can't wait for our schools program the summer after first year to begin. I've spoken to students who have gone and performed simple procedures after being shown how to do them. Try to do that in the "early patient care experience" during your first year in the U.S.

 

[drizzt3117]

I second this guy. At my school we've already seen patients (I'm a first year) but it is all really superficial stuff. We take a history and next year we will be able to do a physical exam. Woop de doo. It would be exactly the same if they just told us how to do it and we practiced it on each other.

EDIT**
Or maybe I'm just biased about seeing "real patients" because I've got about a bajillion hours as a CNA in a hospital.
***

I wouldn't say our school makes a big selling point out of early patient care experience, but I guess we are getting some. They don't let us do much 1st or second year, because there are 3rd years, 4th years, interns, residents, fellows, or attendings to do that. We don't really know much yet. A second year med students isn't a lot more useful than a boy scout. But they can tell you all about complement or mitochondria.

If you really want truly meaningful patient care experience, pick a school that has a strong medical mission program. Sure when you are at a major academic center with CNA's, MA's, PT's, RN's, 3rd years, 4th years, interns, residents, fellows, and attendings they won't let you do anything. But in Africa when it's either you or the medicine man three villages over you get to do alot more. I can't wait for our schools program the summer after first year to begin. I've spoken to students who have gone and performed simple procedures after being shown how to do them. Try to do that in the "early patient care experience" during your first year in the U.S.

During M1 and M2, I put in Foley's, IVs, sutured incisions, scrubbed in on 15 cases, did pelvic and GU exams, etc. The activities were similar to what I'm doing as a M3 but without the responsibility.

 

[justdoit31]

At Tech- During M1 we had clinic once a month as well as 3 specialty experiences and did the H&P and the physical exam with the exception of the pelvic/rectal/neuro which were taught in the 1st month of 2nd year. We also run a free clinic so even our first years can see patients there and do as much as they are comfortable with (last year I drew blood, ran labs, did exams, etc.

During MS2 you are paired with someone in the community and spend at least 1 day a month in their clinic. We can request a field so I am in Pediatrics.

We also have a series of seminars on surgery technique (suturing, scrubing, etc) and then once you get through that you can be in the OR as much as you want as a 1st or 2nd year.

For me having the clinical experienes early was invaluable- it showed me what I was studying so hard for and motivated me to keep working hard. I wouldn't want to go to a school where I didn't get this experience early. Also, it helped during the summer between M1 and MII because I was in the clinic 1-2 days a week as part of my research and I was able to do history and physical, present to the doctor, then present my patients during rounds which I have no doubt will help transitioning to 3rd year easier.

 

[mmmcdowe]

It's a buzz word.