What are doctoring/clinical practicals like at your school?

[surfguy84]

Wondering what the doctoring assessments are like at other schools.

We do a lot of standardized patient experiences during the first two years at our school. Essentially a patient will come in, we take the full H&P, try to make the correct diagnosis, then present to a preceptor the assessment, our plan, etc.

The one thing I've noticed (and what I'm wondering about other schools), is we are dinged points if we don't do a VERY complete history and physical...even for obvious complaints. I recognize the importance of being thorough, but in my entire real world experience visiting doctors (or accompanying a family member), I cannot once recall a doctor being as thorough as they would like us to be. Is this just a pre-clinical year/med school thing?

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[shadowlightfox]

I think it's a pre-clinical/med school thing. I'm only a first year, and haven't gotten deep into history and patient interaction yet, but second years I've spoken to have had similar complaints at my school. Thankfully the class is only a pass/fail, so even if you're not perfect, no stress added.

But yeah, from my experiences scribing, the physicians I worked with clearly did not care about a complete H and P. Only cared about having relevant materials in.

Still, just do as they say, as a steep learning curve can only make leniency provided to you in the future even more pleasant.

 

[surfguy84]

I think it's a pre-clinical/med school thing. I'm only a first year, and haven't gotten deep into history and patient interaction yet, but second years I've spoken to have had similar complaints at my school. Thankfully the class is only a pass/fail, so even if you're not perfect, no stress added.

But yeah, from my experiences scribing, the physicians I worked with clearly did not care about a complete H and P. Only cared about having relevant materials in.

Still, just do as they say, as a steep learning curve can only make leniency provided to you in the future even more pleasant.

Yeah, I'm a 2nd year, so I've gotten into the rhythm of just going with the flow here. was just curious what was happening at other schools.

They grade off a rubric, with questions we "should" be asking... as a rather absurd example, I recently got a patient presenting with nasal congestion which turned out to be sinusitis. I didn't think to ask "do you have a sour taste in your mouth", and was dinged for it. You'd think asking about acid reflux would have been enough (which was its own question on the rubric), but apparently not. But anyways, thanks for your take on things.

 

[jojo58]

We also have a doctoring skills class. So far all we've done is take BP and HR manually. Also hurt each others' eyes with the panoptic.

 

[shadowlightfox]

Yeah, I'm a 2nd year, so I've gotten into the rhythm of just going with the flow here. was just curious what was happening at other schools.

They grade off a rubric, with questions we "should" be asking... as a rather absurd example, I recently got a patient presenting with nasal congestion which turned out to be sinusitis. I didn't think to ask "do you have a sour taste in your mouth", and was dinged for it. You'd think asking about acid reflux would have been enough (which was its own question on the rubric), but apparently not. But anyways, thanks for your take on things.

Wow I hope I don't get that similar of a stickler for my exam haha. But at least now I know to ask that question whenever I see a patient with a nasal congestion.

 

[ortnakas]

At my school you have to do full H&Ps for exams in your first year. They want to see if you can really get through everything, even if in real life you're not going to be doing a full physical very often. Our second year is more about doing focused H&Ps for specific complaints.

 

[Drrrrrr. Celty]

At my school you have to do full H&Ps for exams in your first year. They want to see if you can really get through everything, even if in real life you're not going to be doing a full physical very often. Our second year is more about doing focused H&Ps for specific complaints.

This is how it is at KCU.

Personally I think first year is about getting into the comfort and habit of knowing things to ask and the basics of stuff. Second year is more real problem focused examinations and getting your flow down right.