Questions for med students about 1st and 2nd year

[FloridaMedicine]

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Hey you guys, if you guys can afford some time in between studying can any of you guys answer this for me? I wanted to know how much paitent interaction did you guys had during your 1st year and 2nd year? If so what did you guys have to do? I'm trying to decide between a modern and a traditional school and I wanted to know what are the significant differences. Thanks in advance you guys.

 

[emsdan]

I probably shouldn't be on here with anatomy exam 1 in the morning, but whatevs.

Clinical interaction consists of 3 parts: Information gathering, diagnosis, and plan for treatment. Any patient interaction you have during the first 2 years will focus on the interview because you don't know nearly enough to start to comprehend diagnosing.

Some schools require you to do a certain amount of "preclinical" clinicals to work on this, and that is great - you should do that.

But, for schools that don't require it, throw on a shirt and tie, grab your white coat, and head to the ER. Unless you are at some crazy private hospital, they won't say no to you sitting down and talking to people who are waiting for a room to open up. Or call a resident or attending in a specialty you are interested in and ask if you can come talk to some patients. No one will say no to this and your experience will probably be better than any required clinical work through the school.

In the end, all you are doing is talking, so if you can hold a conversation and memorize 3 or so mnemonics, you'll be fine wherever.

 

[thepoopologist]

Hey you guys, if you guys can afford some time in between studying can any of you guys answer this for me? I wanted to know how much paitent interaction did you guys had during your 1st year and 2nd year? If so what did you guys have to do? I'm trying to decide between a modern and a traditional school and I wanted to know what are the significant differences. Thanks in advance you guys.

At my school:

First two years are required preceptorships. It usually amounts to 6-7 outpatient visits a semester.

My first year was taking histories on patients. Second year is history and physical. Both years the docs made me present. I do have to mention that I didn't know anything the 1st semester of 1st year and felt like a ***** taking histories back then.

I like it, and it adds some relevance to my studying with regards to knowing what is actually used in practice.

Turns out the best docs remember a lot of 1st and 2nd year basic science and how to implement it into making a diagnoses.

 

[thepoopologist]

I'm a second year btw

 

[mdeast]

Most of the first two years is based on getting basic patient interaction skills...how to gather information, talk to patients, perform a physical exam. You also have opportunities via various training sessions to learn practical skills (TB tests, blood draws, blood pressure, blood sugar, etc.).

It works differently at every medical school. Where I go, we practice interviewing skills with Standardized Patients (i.e. actors) twice a week during the first year.

Second year clinical experience is spent in practicum (shadowing) one afternoon a week in an affiliated hospital (university hospital, local VA, county hospital, etc.).

There are a ton of outside opportunities to get involved in more direct patient care. You can (1) join the flu vaccination team (2) get involved in community health fairs (3) take elective courses on longitudinal patient care (pediatric chronic illnesses, pregnancy, etc.) (4) volunteer in the free clinic (5) shadow a professor or lecturer.

I really like the free clinics...because your patients are always super appreciative of your work, they mind less that you don't know what you're doing, they're OK about spending 45 minutes with you going through every detail of their medical history, and (again) they also don't mind if you perform procedures. You also learn to present to attendings (usually residents or academic docs). Free clinic also presents the opportunity to see a pretty underserved patient group, so you really feel as though you're making a difference. I've taken blood pressure, TB placements, flu shots, and even got to administer a steroid injection into a keloid scar last week in derm speciality clinic. And I'm just a MS1. It's actually pretty good practice for the type of things you'll have to learn to do for third year rotations.

You're busy enough with classes and exams and just learning a whole bunch of information...but there are definitely tons of opportunities for clinical experiences when you have the time. Just don't expect to be contributing to a diagnosis when you're a MS1. You just don't know enough yet.

Now...back to my succinates.....

 

[mvenus929]

Technically, we saw patients on our 'first' day of med school (beyond the orientation stuffs). We have patients in front of us nearly every week to learn about various diseases and how the patients responded. We have had a few interviews with real patients (first diabetic patients, then pregnant patients). We've witnessed real patient interviews in a small group setting (we went up to the hospital in small groups and watched our mentors interview the patient). We've done a fair amount of standardized patients interviews as well.

Our curriculum is new, so we don't know what we're doing next week, let alone next year, but in the past, they've had a psych section where they've gone to the community hospital in town and interviewed psych patients, then did write-ups on them. They've also done full history and physicals their second year, and have to pass a standardized patient exam to get onto the wards for clinicals.

 

[Bacchus]

We have a course called PCS (Primary Care Skills) that encompasses physicals and histories. We have 5-6 standardized patients a year plus an OSCE (final patient exam) at the end of both years. Our clinicians hold document review sessions so we can learn how to write better notes. In our second year we have "morning report" type sessions where two students present two cases, admitting "patients" into the hospital.

 

[Narmerguy]

See signature.

 

[gravitywave]

consider other factors before you consider this one. The level of patient interaction that M1/2 students get is superficial at best, no matter where you go. I too focused on this when I was in your shoes, but the truth is that it's not terribly important.

More important things are, in no particular order: cost, location, grading scheme (P/F >>>>>> ABCF), curriculum structure (look for research emphasis and truncated pre-clinical time), clerkship structure (for time/sites/specialties emphasized).

 

[FloridaMedicine]

wow thanks for replying you guys this is good stuff!! i want to hear more. How did you guys do the first time with your paitients? Were you nervous?

 

[ksmi117]

Hey you guys, if you guys can afford some time in between studying can any of you guys answer this for me? I wanted to know how much paitent interaction did you guys had during your 1st year and 2nd year? If so what did you guys have to do? I'm trying to decide between a modern and a traditional school and I wanted to know what are the significant differences. Thanks in advance you guys.

I'm a first year and my school has us in the hospital every two or three weeks practicing our interviewing and physical skills. We have separate small groups to discuss and learn how to take a history and do a physical. Then they send us into the hospital. We also have PCPs that we shadow throughout the year.

consider other factors before you consider this one. The level of patient interaction that M1/2 students get is superficial at best, no matter where you go. I too focused on this when I was in your shoes, but the truth is that it's not terribly important.

More important things are, in no particular order: cost, location, grading scheme (P/F >>>>>> ABCF), curriculum structure (look for research emphasis and truncated pre-clinical time), clerkship structure (for time/sites/specialties emphasized).

Totally agree with this. It's nice to go into the hospital and all, but it's really not something that should make or break your decision. No school is going to keep you away from patients. It may just take more effort on your part to see patients if your school doesn't have you in the hospital/clinic that often.

wow thanks for replying you guys this is good stuff!! i want to hear more. How did you guys do the first time with your paitients? Were you nervous?

Yeah, it was a little nerve-wracking. The thing is, you don't really know what to ask patients in an interview the first time. You don't know what symptoms mean what and so once you get through the generic list of questions that you ask everyone, it's hard to just come up with things to ask. You get used to the style and flow of how things should be really quickly though.

 

[vc7777]

I'm a first year at the Cleveland Clinic.

We are a 5 year MD/MS medical school and a very small class size (32). We start our first year with 10 weeks of intensive basic research. At the beginning of our "normal" school year, we started seeing patients in longitudinal clinics.

Every other week we have clinical skills (where we are observed with standardized patients) and physical diagnosis practicums that correspond with our block.

Longitudinal clinic is a 2 year experience with a one-on-one mentor in primary care either at the main campus or in out-patient clinics (I'm about an hour away from the main campus). It is on opposite weeks as clinical skills and physical diagnosis.

LC is a combination of seeing patients by yourself, watching your preceptor, and being observed while you lead the visit. By the end of our first year were are supposed to be doing the basic ROS and presenting patients to our preceptors.

We also have OSCEs ("ahhh-skis") at the end of years 1 and 2.

 

[Meerkatology]

but who cares whether/how much you get exposure in m1 and m2 or not?

you will have more than enough of it in M3 and M4. whether you do it in m1 or m2 isn't gonna affect your education in the long run

 

[Bacchus]

but who cares whether/how much you get exposure in m1 and m2 or not?

you will have more than enough of it in M3 and M4. whether you do it in m1 or m2 isn't gonna affect your education in the long run

It's nice to look like less of a fool than expected and it makes you look like you have some form of intelligence even if its lacking.

Looking at where I've come from last year to this year, my H&P skills improved greatly. They aren't anywhere near where I would like them to be, but knowing that I can form some semblance of a careful thought out DDx from my interview/physical makes me feel somewhat accomplished. And if that all falls away, at least I know I am now comfortable to be in the same room as a patient.

 

[FloridaMedicine]

but who cares whether/how much you get exposure in m1 and m2 or not?

you will have more than enough of it in M3 and M4. whether you do it in m1 or m2 isn't gonna affect your education in the long run

Dude I care thats why I asked. Perhaps this shouldnt impact my decision too much but i'm more of a "hands on" student. I like to get involved because i learn more this way. Don't get me wrong I can easily do a traditional school but I have been reading about some schools who give their students more of a hands on approach from day 1. According to some schools like UCF some students have been doing alot better this way. I believe duke's clinical years starts during year 2 during med school.

Thanks to everyone responding this is really intresting to me, and I could understand not knowing which questions to ask right off the bat. There isnt enough info on what 1st year and 2nd year students do other then bookwork. So at what point do you guys feel confident with your interview skills?

 

[musafirah]

http://forums.studentdoctor.net/showthread.php?t=104541
all you need to know

 

[Forthegood]

but who cares whether/how much you get exposure in m1 and m2 or not?

you will have more than enough of it in M3 and M4. whether you do it in m1 or m2 isn't gonna affect your education in the long run

Missing the point. Early clinical stuff really helped my attitude towards the whole med school thing.

School is always a downer. Seeing patients can be a downer, but it also has a much needed upside. It is nice to have a reminder why we are doing this.

 

[slowbutsteady]

Dude I care thats why I asked. Perhaps this shouldnt impact my decision too much but i'm more of a "hands on" student. I like to get involved because i learn more this way. Don't get me wrong I can easily do a traditional school but I have been reading about some schools who give their students more of a hands on approach from day 1. According to some schools like UCF some students have been doing alot better this way. I believe duke's clinical years starts during year 2 during med school.

Thanks to everyone responding this is really intresting to me, and I could understand not knowing which questions to ask right off the bat. There isnt enough info on what 1st year and 2nd year students do other then bookwork. So at what point do you guys feel confident with your interview skills?

Dude, listen to these people. Whatever you "get your hands on" during years 1 and 2 will not help you learn. You have to learn first how a healthy body and a sick body work before any "hands on" experience will help you. Once you learn that, then you learn from "doing" and that is what years 3 and 4 are for.

I agree with above posters that a little exposure to patients is nice because it starts the process of handling patient interaction. People skills, folks, that's all it is!!

But it doesn't TEACH you medicine.

I love how premeds ask med students about something and then get pissed if they don't like what they hear.

I'm glad I was never a premed cuz they are lame.