Perspective??

[Mom2five]

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Husband is having a hard time...he's done IM and now on Peds. He is not agressive and still feels dumb doing H&P. Is there some sort of resource I could find where I could say "I have xyz symptoms" so he could practice with me?? He is someone who needs lots of practice to feel sure of himself. Has performance anxiety and is questioning med.school in general. Any advice on how to help him?

I have bookmarked "3rd yr. stress" threads for him to look at. Heck, I've come short of actually putting on the cheerleading uniform (which I was glad to leave in H.S.) I tell him that everyone is feeling this way etc. and while he can realize that it is still hard to get over the fear. I told him he has to get over himself and remember that it is about taking care of the patients and to just try to learn one new thing a day and to focus on making patients feel at ease. He scored very high on Step I and think he has pressure/issues with continuing that kind of performance in clinicals. The mountain of debt doesn't help because he feels more pressure to pursue a higher paying field just to repay loans. I said "don't you think I'm talented? I'm capable of making $$ so you just find what you like and I don't care what field it is...kids will be in school, I can work, etc." It's hard to see someone you love so much and that is so talented and kind doubt their abilities... 🙁

 

[oldbearprofessor]

Dear "Mom":

I hope you will get some good advice and reassurance from current medical students. Let me give you some from someone who was in your husband's position when Jimmy Carter was in the White House.....

First, if at all possible, try to seek out a faculty member to talk with about how he is doing and also to reassure him that his experience is normal for many 3rd yr medical students. Some faculty are not well suited to that conversation, but there are sympathetic faculty out there who can be of help. It's worth the effort to find them.

Second, although I know it is the near universal advice on this board to seek out the career in which one can make the most money with the fewest hours and least high-stress patients, this is not what everyone is suited for. There are some people whose life is happiest with an older car, smaller house and a job they really love doing. I know lots of such folks 😉. Perhaps your husband, with your support, can think about looking at rotations in fields like pedi not as an opportunity to shine so he can have a chance at a field in which the pay/hrs ratio is highest, but one in which he can come home satisfied with what he is doing. If that is a high paying specialty, great, but if not, well, think about what matters and make your choices.

Meanwhile, don't panic at 3rd yr angst. It is nearly universal. We faculty have seen it before 🙂

Regards

OBP

 

[Mom2five]

Thanks, I have been soooo supportive and have told him to do whatever he likes with no regards to prestige or money. I did not put in all this time/effort/stress (yes, not just the med students are stressed) to have him pick a career he doesn't enjoy. I want his time away from us to pass quickly because he truly loves his work. Right now he just misses the kids and keeps threatening to send me to law school and him stay home with the kids! I said sure after you finish. My Mom comes in a week for a visit and hoping hubby and I can go talk to someone.

 

[StringBean]

Hey Mom2five,

Please tell him we've ALL felt like that. Time and practice will help! It's great that your looking for a way to help him practice and the support your showing will work WONDERS! There's nothing better than having someone listen and comfort you when your stressing though the hell of 3rd year. It's quite amazing how you can come so far having gotten into medical school, taken and passed Step 1, and yet feel stupid and inadequate everyday! I've been (and still am, although a 4th year now) there!

I don't know of any sites that will give you specific patient senarios but you can still help if you follow the basics of a H&P. Ask him if he's received anything at school outlining how to take a history and physical. You can hold a copy of it as he's asking you questions and you can put a mark next to the areas he missed. For example, you pretend your having abdominal pain (you can make up random symptoms if you'd like. There's no need to know about medicine to help him here) and as he does the history you keep an eye on the paper & be sure he's asked it all... like family history, what meds you on, etc, etc. Same with the physical, ask him for an outline and just check them off as he goes though them & let him know what he's missing.

Some other things that may help...

Since he's doing peds right now tell him to check out this peds H&P card at http://www.medfools.com/downloads/peds_HandP.pdf
He can print it up & glue it to an index card so he can whip it out discretely during an H&P... after a few times he won't even need it anymore! It's all about practice... felling comfortable knowing what questions to ask will come with it.

That same site has great outlines & helpful printouts for all rotations. Have him look through them.
http://www.medfools.com/downloads.html

I also found that taking & writing up some extra H&P's when i had some extra time helped. I would tell patients that I was part of the team taking care of them and ask if they'd mind if I asked them some questions. I'd explain that they have probably already been asked most of the question I will go though but that sometimes getting multiple hisories at different times can be helpful in obtaining more precise information regarding the patients illness. Of course if he's going to do this he needs to make sure it's OK with that patient's resident/student to be sure he's not stepping on anyone's toes. The best part about doing this is that you can write it up w/o the stress of it having to be perfect (cuz it's not going into the chart and nooone else has to see it) and then he can go and compare it to the resident's H&P to see if he's missing anything or just to find better ways to organize the information that he did get.

OK, that's it i guess. I hoped this helped a bit. Tell him to hang in there... it does get better!

If you (or he) has any other questions... or if he just wants to chat, feel free to PM me!

Good luck to you both!
~Bean

 

[Mom2five]

Awesome...thanks StringBean!

 

[DOtobe]

Your husband is definitely not alone! All of us have felt nervous doing H&P's and felt like we were stupid sometimes (but we aren't!) It takes a while to get comfortable with doing H&P's - I don't think I was really comfortable until near the end of my third year. I know that I found an H&P card in my school's bookstore - it fits in your pocket and has pretty much all the questions you need to ask for the H&P (similar to those on medfools that String Bean mentioned).

Third year is a difficult time because you are learning so many new things and trying to find your place in the hospital...but it will get better. Tell him to hang in there!

A book that may be helpful is the First Aid for the USMLE Step 2 CS book, which has different patient scenarios, and then a checklist following it of all the questions that should be asked. You could pretend to be the patient, and then check off the questions as he asks them...

 

[sapience8x]

wow! i wish that my husband would do that for me! I think i may have to ask him soon though. i just can't get used to thinking on my feet!
anyway, any case series should help. You have the blueprints clinical cases, underground clinical vignettes cases and you can look for these cheaply on amazon used or ebay.
good luck with everything and continue to be supportive!

 

[fang]

1st of all, I think the cheerleading thing is a great idea-- I wish someone would do that for me once in a while!! (unfortunately, my cat hates miniskirts.)

Like your husband I did great on step 1 and feel some pressure now about performing well in clinicals. However, it's really counterproductive to be contemplating grades all the time, b/c it makes you even more uncertain and timid. I have a hard time following my own advice here as well, but I think the best way to get through the stress is to forget about the grading, think about how you could have done things differently if you screw up, and then let go of it. (or possibly plot revenge, depending on what happened.)

Another option if he's shy about H&P's-- doing clinical volunteer work really helped me with that. It's all about the practice!!

Finally, I would personally rather have a shy doctor who really thinks about what's wrong with me rather than someone who talks all the time but comes to hasty decisions. I don't think he should reconsider med school just because he's not agressive... I'm sure after 5 years of doing this it won't feel awkward at all.

 

[bigfrank]

You should definitely "surprise" your husband with the cheerleader-thing.

 

[IlianaSedai]

This WILL pass. He WILL get used to doing the silly H&P's without having to worry so much about them. However, it took me 6-8 months before I stopped WORRYING about how I was performing all the time. It's simply a matter of getting used to the new environment.

I don't think you need to find resources to help him study or learn. There's absolutely no expectation that a medical student will get everything right. There's no expectation that a resident will get everything right either. That's why you have someone more experienced supervising you, reviewing everything and making corrections and suggestions! For me, if there's something I need someone to help me practice with, I'll ask for it. I can say "I need to practice going through a complete physical exam, will you help me?" And if I need to practice taking a medical history, I can provide my helper with the correct information to go through it with me. I think, as a medical student, if your husband needs help, he'll be able to provide you with the right information and guidelines to help him.

 

[Mom2five]

You should definitely "surprise" your husband with the cheerleader-thing.

hmmmm....should I skip the bloomers? 😉

 

[Mom2five]

Thanks everyone...I had him read this post and he feels better. He just needs lots of practice. I just finished taking a college class and don't plan on taking any for awhile (I was filling in the fin. aid gap during his downtime from school). That already takes a huge stress off of us cause now all free time can be his to study. I can focus a little more on the kids and getting us on all a schedule. Summertime is a little crazy with kids...they are bored etc. Plus we have only 1 car that he takes everyday and that gets OLD. Having such a large family also puts fin. pressure on hubby. Well, thanks again!!!!