During my third year of medical school, I would often tell my parents about my days on the clinical wards. As physicians, they were excited that I was following in their footsteps and eager to engage me in conversation about my education as doctor-in-training.
“So,” they would ask, “did you draw the blood for the labs?”
“No, I don’t think I’m allowed to do that. The phlebotomists do that job,” I’d answer.
“Wow. You guys really don’t do much,” they’d reply.
My parents were educated at the Royal College of Surgeons in Ireland. They described their medical school clinical years as quite grueling, but an experience they were ultimately grateful for because they actually learned how to do tasks that are often outsourced to other medical professionals like phlebotomists and nurses. This made them better clinicians and gave them an advantage over co-workers and co-residents when they transitioned to practice in the United States. My parents say their experience was so hands-on that, with supervision, they could perform a routine appendectomy by the time they graduated in 1986. I wondered why I wasn’t learning to do that same.
While on the wards, I remember a few occasions distinctly thinking that my resident was trying to shake me. I’d pause to jot a note or look away for one second and “poof,” the resident had vanished. I wanted to learn and participate in the care of our patients, but given their tremendous workload, I didn’t blame them for slipping away when they had the chance. The obligation to teach me had very little payoff when I wasn’t allowed to do much to boost efficiency or reduce my resident’s work burden.
Many medical students feel the same way. My friend Daniel Luftig posed the following hypothetical question to a number of our classmates: “Suppose all the medical students in the health system instantaneously vanished. What would happen to the hospital workflow?”
Most gave the same gut response: “Nothing.” Outside of the intangible benefits that a student’s bedside presence often brings to patients, some of our classmates even said that things would improve if we were removed from the equation entirely. The notion that medical students decrease workflow efficiency is nothing new, as captured by the age-old quip among house staff: “Show me a medical student who only doubles my work, and I’ll kiss his feet.”
It is no secret to the medical education community that students are becoming increasingly marginalized in the educational workplace. While I often found myself chasing residents or looking for ways I could be useful, when they were medical students my parents performed regular patient care tasks such as documentation, phlebotomy, IV insertion, etc. When it comes to the medical workforce, we represent opposite ends of the spectrum. Historically, students may have actually been exploited but today, they are largely under-utilized.
For this reason, Daniel and a group of students from the University of Virginia School of Medicine have banded together to improve the student workplace experience. Their demands are quite different from those of typical unionized workers: “Exploit us more,” they ask. (But not too much, of course.) Operating under the moniker of Resuscitating Clinical Education, they’re focusing their initial energies on reviving the student’s role in documentation. The specifics of the issue can be found in their online petition and corresponding 90-second video.
They believe this change would improve our documentation skills by providing students superior feedback on their notes. As it currently stands, many students already write regular notes on their patients – the issue, however, is that they are rarely read. Having a physician adopt and edit a student’s note would allow the student to see specifically what should have been added to, removed from, or changed in his or her final product. Thus, a feedback system for medical documentation would be built into the daily workflow, and students would graduate with enhanced competency in this critical clinical skill.
Instead of lurking the halls and waiting for our residents to resurface, medical students want to make tangible contributions to the team for the intrinsic fulfillment that comes with meaningful participation in patient care. This sort of participation will allow us to ease the work burden of our residents, which would provide these experienced clinicians more time — and motivation — to teach us. Resuscitating Clinical Education believes that the enhanced sense of team participation would improve general student morale in the clinical environment. I’m sure other medical students across the country would too.
Jennifer Adaeze Anyaegbunam is a medical student who blogs at her self-titled site, Jennifer Adaeze Anyaegbunam. She can be reached on Twitter @JenniferAdaeze. This article originally appeared in The American Resident Project.
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