This morning as I was brushing up on my medical news I came across an article in The New York Times’ Well blog entitled, “Are Med School Grads Prepared to Practice Medicine?” As an entering medical student of the Class of 2018 I was immediately drawn to the piece. Is it possible that I will spend the next 4 years of my life buried in books, engrossed by education, surrounded by patients and established physicians and still not be ready for residency? Oh god… The author of the article, Pauline Chen, M.D., recalls a specific occurrence that took place during her intern year. A fellow intern, who attended a school apparently uninterested in teaching phlebotomy, had spent nearly an hour poking and prodding a patient, attempting to find a vein. The patient, as one can imagine, was not thrilled, yelling, “I’ll hit you if you come near me again!” Another intern was able to help and perform the phlebotomy flawlessly, but admitted to being unprepared to prep a patient for surgery. The problem, thus, is the differential focus of medical schools in educating their students. While one school flawlessly prepares their students on oral presentation of a patient, another emphasizes careful reading of images. The discrepancies are unforgivable and highlight an even more important issue than lack of surgical skill: lack of communication. Instead of working as parts of a seamless and well-conceived whole, medical schools and residencies are operating independently of one another, teaching and emphasizing aspects of medicine that weren’t always relevant to the next step of a young doctor’s career. It is often said that medical school interviews are not meant to assess your intelligence. Admission offices have seen your metrics. They know your GPA, your science GPA, your MCAT score and how it was broken down by section. They know you created a scaffold for the growth of tenocytes and that you were president of the robotics club. What they don’t know, and what they hope to gleam from your interview, is your ability to communicate, to relate to another individual on personal level, and even, to admit your weaknesses. When I was preparing for my interview season and met with a medical school faculty member to conduct a “mock” interview, one of the questions he asked me was, “What are your 3 biggest weaknesses?” As I prepared to answer he added the caveat, “And don’t give me a roundabout answer where you try to make your weakness into a strength” (ie: “Sometimes I am TOO dedicated to my studies and it often compromises my social life.”) The thing with the medical profession is that it requires an acceptance of shortcomings. One should become a doctor not to feed his or her ego but to serve a patient and sometimes, if not often, this means asking for help. It means admitting your faults for the sake and safety of your patient. In the New York Times article, a paper was cited which highlighted a study conducted by physicians who were aiming to bridge the gap between medical school and residency training. “Clerkship Directors in Internal Medicine subinternship task force, in collaboration with the Association of Program Directors in Internal Medicine survey committee, surveyed internal medicine residency program directors to determine which competencies or skills they expected from new medical school graduates.” Researchers were not only alarmed by the uniformity of responded obtained by also on what they agreed on: less than 5% of internal medicine physicians reported that they believed graduating medical students need more medical knowledge or procedure experience. An overwhelming majority deemed the most important skills for residents to be “organization and time management and prioritization skills; effective communication skills; basic clinical skills; and knowing when to ask for assistance.” The lead author of the study explains that until now, “‘we educators had this silo mentality and were thinking, ‘I know what my job is, and someone else can deal with what happens to the students before or after.’’” But being a physician means being part of a medical team, of which doctors are only a part. Nurses, physicians assistants, techs, even family members of patient, are all part of the care and outcomes of a patient. While a burden now rests upon the AMA to begin taking into consideration the discrepancies that occur in medical education, it is also the responsibility of our own as “almost” docs to acknowledge our gaps in knowledge and to recruit the help of others. Who knows? You may learn something along the way. Source
