Nathaniel Fleming

Nathaniel Fleming is a medical student who blogs at Scope.

The tension between learning and the illness of others

Medical Education

July 9, 2019

Every doctor and doctor-in-training has a particular thing that drew them toward a career in medicine. Whether it is an interest in science, a passion for service and helping others, a family role model, or a combination of the above, there are many ways to spark interest in the field. From my own experiences and conversations, I’ve found that finding inspiration to enter a career in medicine is rarely a …

You’re lucky to have a medical student in the family

Nathaniel Fleming

Medical Education

July 2, 2019

One of the most common experiences faced by a medical student is being asked for health care advice from a friend or family member. My initial reaction to these questions is usually something along the lines of, “Are you sure you want to be asking me that? I’m not even a doctor yet!” This is especially true when the question is about something that I’m not particularly experienced in (which, …

3 things I wish I had known before starting medical school

Nathaniel Fleming

Medical Education

April 1, 2019

I wish the best of luck to everybody applying to medical school. As somebody who was in this position five years ago, I wanted to take this opportunity to reflect on some of the things I wish I had known before I started medical school.

1. Look beyond the first two years, because the clinical years are the meat of the training

Many applicants focus mostly on the preclinical curriculum of a …

Why medical students need more continuity of care training

Nathaniel Fleming

Medical Education

February 18, 2019

One of the major challenges of being on medical school rotations is the necessity of changing rotations every four weeks, and how adapting to each new specialty feels like going through the first day of school all over again.

I want to share my experience on other side of the coin. About a year ago, I started participating in Stanford’s Continuity of Care program, a clerkship in which I am excused from …

A medical student after an OB/GYN rotation: Here’s what he learned

Nathaniel Fleming

Medical Education

December 23, 2018

On one of my first days on the labor and delivery ward, one of the attending obstetricians asked me what area of medicine I was interested in. When I said that I was applying into neurology this year, she said, “Ah! The other end of the body!” After a pause, she continued, “Well, this rotation will be … different.”

It wasn’t the first, or last, time I had heard a similar refrain during …

Embrace the teamwork involved in becoming a physician

Nathaniel Fleming

Medical Education

November 12, 2018

It’s Sunday, and the clock is approaching 8 p.m. Every computer in our team room is still on, and the sound of typing is filling the small space. A spread of snacks, interspersed between stethoscopes and stacks of faxed records, is ignored for the time being.

This scene was a familiar one on inpatient medicine, where call days can stretch long into the evening. Although those days were challenging and draining, …

Don’t worry, medical students don’t judge

Nathaniel Fleming

Medical Education

July 7, 2018

Everybody gets nervous at the doctor’s office. Physicians ask all sorts of personal questions about what people eat, how much they drink, and how things are at home. Even questions that would seem completely harmless in another context — such as how work is going, or what hobbies a person enjoys — seem surrounded by hidden meaning and purpose. After all, who doesn’t want to “pass” their annual checkup?

Part of …

Bridging the gap: medical training in the digital age

Nathaniel Fleming

Medical Education

May 2, 2018

Like most medical trainees my age, I step into the hospital with the entire knowledge base of the world in my pocket. I have apps on my phone to look up disease symptoms and diagnoses, reference drug doses and side effects, estimate the 10-year risk of having a heart attack, determine the correct timing and type of vaccine administration and screening tests, and even display the risks, benefits, and statistics …

Taking off the training wheels and becoming a real doctor

Nathaniel Fleming

Medical Education

April 12, 2018

Working in a clinic as a medical student is the best of all worlds. We have the opportunity to expand our knowledge and skills by working with some incredible patients, all while knowing that we have the support and backup of our fully trained, expert attending physicians every step of the way. This apprenticeship type of system is absolutely essential to medical training, allowing us to get our feet underneath …

What do you say to somebody who knows that they are about to die?

Nathaniel Fleming

Medical Education

January 16, 2018

I’ve had lots of practice comforting people. I’ve had to tell patients that their cancer is back in a busy emergency department. I’ve updated family members of patients who are being kept alive by machines in the intensive care unit. I’ve walked alongside patients as they get rolled into an operating room, and crouched down by a patient’s bed as they writhe in pain. There have been moments of fear, …

The challenges and rewards of being an introvert in medicine

Nathaniel Fleming

Medical Education

November 15, 2017

More than two years ago, I wrote about some of the obstacles — as well as the opportunities — that introverted medical students face during training. Now that I have many rotations under my belt, it’s time for an update about my experiences on rotations, along with some helpful advice to newcomers.

The challenges

First, the challenges: Medical school rotations are very fast-paced, and our team members (co-workers and superiors) …

A day in the life of a medical student

Nathaniel Fleming

Medical Education

July 24, 2017

Have you ever wondered exactly what it means when a medical student is “on rotations”? We always claim that we’re busy, but just what is it that we do all day? To answer these questions, here’s a recap of one day from my inpatient pediatrics rotation.

5:27 a.m.: I pull out of the parking lot and start the now-familiar early morning commute down I-280 to San Jose. The good thing about …

Read more…

A day in the life of a medical student

This is why access to health care matters

Nathaniel Fleming

Health Policy

June 30, 2017

As our elected officials consider to weigh the future of our nation’s health care, I thought I would take the opportunity to share a few vignettes of patients that I’ve encountered this year who exemplify the way that access to health care can make the difference between life and death.

The undocumented immigrant with seizures. We recently met a young undocumented Californian in his twenties in the emergency department, who came after …

When the medical student isn’t the most important person

Nathaniel Fleming

Medical Education

May 30, 2017

For the first two years of medical school, everything was all about us.

Day one was our white coat ceremony. Our family and friends traveled from near and far to come celebrate our achievements; the school gifted us stethoscopes and white coats to mark the beginning of our journeys. We had already accomplished amazing feats to get here, we were told, and we were expected to continue to do great things. …

The medical student’s ultimate challenge: children

Nathaniel Fleming

Medical Education

March 1, 2017

During the first year of medical school, one of the most nerve-wracking, but exciting, experiences was learning how to interview and examine patients. At that time, we mostly worked with “standardized patients” — people who are trained specifically to play the role of a scripted medical case. Although working with them seemed incredibly challenging at the time, the rules of engagement were in fact very favorable to us. Asking a question …

How should you choose a medical specialty?

Nathaniel Fleming

Medical Education

January 17, 2017

Many people know that an important part of medical school is choosing a specialty — the field of medicine that you plan to practice for the rest of your career. However, fewer people know just how many different factors weigh on this decision. As my classmates and I navigate through third year, I thought I would share several of the factors that enter the balancing act:

Clinical interest: The simplest, yet …

This is what the election taught me about medicine

Nathaniel Fleming

Physician

January 1, 2017

The morning after the recent presidential election, I entered our clinic building feeling as though I was in a daze. Like many people, I had stayed up late following the election results and trying to understand what they meant for our collective future. I could see our country’s divisions fresh in my mind. I could picture the electoral map, with each state colored firmly either “red” or “blue;” I could …

Why the third year of medical school is like the first day of school

Nathaniel Fleming

Medical Education

October 13, 2016

There is no feeling that is quite the same as the “first day of school” — a blend of excitement, nervousness, and uncertainty that almost every student experiences from first grade through college (and sometimes beyond). By now, I’ve had a lot of “first days” in my life. Even so, when I officially started my clinical rotations just over three months ago, that all-too-familiar feeling of nervous excitement was reliably …

Medical school: A crash course to critically appraise information

Nathaniel Fleming

Medical Education

July 23, 2016

The question, asked to me by a new first-year medical student, seemed simple enough: “There are a lot of different types of reflex hammers out there — which one should I buy?” As with so many things in medicine, however, I knew that my answer wouldn’t be so straightforward.

As I prepared to answer, I flashed back to one of my first days in medical school, when one of my clinical …

How a TV medical drama gave this medical student confidence

Nathaniel Fleming

Medical Education

June 16, 2016

When I was in high school, I remember being fascinated by the television series House the medical mystery show whose title character was the doctor version of Sherlock Holmes (only with non-existent ethics and a drug problem). Back then, of course, I didn’t have much understanding of the medicine behind the show, but I was impressed by the show’s apparently realistic use of medical terminology and the way it made the …

Nathaniel Fleming

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