Having a Positive Experience in Clerkship (Part 2)

In part two of this mini-series on clerkship, we will hear from current clerk, Golshan.

Golshan, Class of 2019:

“Clerkship has been one of the most unique, challenging, and rewarding experiences!

We have spent long hours studying for exams in undergrad making sure we get stellar grades, then summers preparing for the MCAT. In the first two years, attending lectures and preparing for OSCEs to set the foundation for clinical medicine. You will feel like you are finally doing what you came to medical school to do. Interacting with patients, learning people’s stories, working and learning from great physicians in hospital – it’s a totally different type of medicine.

And in one year you will be surprised with how much you will learn! Embrace the opportunity. How many people get to say they delivered a baby, were first assist with a lobectomy, got to see a patient’s progress from admission to discharge?

Your preceptors have all been students in the past.

As much as it can be intimidating working with a preceptor, remember, that they have all been through what you have been through. They will try to help you out.

My first rotation was obstetrics and we had a morning C-section scheduled. The room was packed with anaesthesiologist, obstetrics, first assists, nurses etc. My primary goal was not to contaminate the sterile field. I was in my scrubs, had a mask on and hair cover. However, the pediatrician could still see the sheer fear in my eyes, I was a deer in headlights – he came over and said don’t look so anxious, we’ve all been there. He told me to come over to the warmer, gave me the blanket and told me to start stimulating the child when it was delivered. That day, he taught me how to do a full newborn exam and told me to do the rest of them.

You will pick up on things quickly and surprise yourself multiple times in clerkship.

You will grow as a person and a student.

The first few weeks in any rotation, everything will feel new and uncomfortable. You will make mistakes, you will feel incompetent, and you will question yourself. This is normal, and everyone will feel like this at some point. Overtime you will become more comfortable feeling uncomfortable.

In clerkship, you are allowed to make mistakes, it’s okay to say I don’t know. You have a safety net in place. Use the opportunity to go out on a whim, come up with a work-up and management plan for your patients, even if it’s is completely wrong.

One preceptor on my CTU rotation told me something that stuck with me and I tried to use for the rest of my rotations: take care of each patient like you are the only person responsible for that patient.

There was one patient on my CTU rotation that resonated with me. She was a frail but sweet elderly woman, with multiple co-morbidities. Her son had brought her to emergency as she was not eating and losing weight. Her kidneys were also failing her. Her GFR continued to drop by the day to single digits, but she was adamant that she didn’t want dialysis. I would come to check up on her every day, see if the rash on her leg had improved, if she was eating her breakfast, and update her family about the plans.

During her three week stay in hospital, I saw her go into a delirious state and come back. I saw her being hopeful and hopeless. After those three weeks she was discharged to a hospice for palliative care. I didn’t have a chance to say goodbye to her.

The CTU resident came up to me and said the family wanted to thank me for taking such good care of their mom.

I didn’t think that I was doing much, but after this I realized how we can make a big difference for patients.

It’s not all about medicine. 

It can be difficult to make time for other activities when you are working long shifts, have pages and pages to read or are just plain tired from being on call. Make sure to take care of yourself, whatever that may look like for you.

Winter time I decided I needed to make some time for yoga. Coincidentally I ran into a preceptor at the class. She told me that she had been coming there for three years and that it was her way of keeping sane for the week to follow.

This year will be a difficult. They don’t call it The BIG 3 for nothing. You will rely on your classmates, friends and family more often than not. Talk to family, friends and student affairs if you are having a bad day or if you feel mistreated.”

It can be difficult, but take heart in this, fellow SMP students:

“We are so lucky in Kelowna. The preceptors have all been so great. They are all enthusiastic about teaching.”

 

Stay tuned for the third, and final, part of this series, which will include our final clerk telling their story as well as my thoughts on this whole experience.

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