February 2017

Having completed a few months of clinical practice, I finally understand what one has to do to cross between preclinical and clinical medicine. Leaving the comfort of lecture theatres and transitioning into a hospital environment is by all means as daunting as it sounds. When attending a lecture, all you need to do is sit back, listen and absorb the information that the lecturer is trying to convey. Clinical years of medicine are far more independent and the saying “what you put into things is what you get out of them” could not be more true.

he “Junior Medicine & Surgery” portfolio and log book give us a sense of direction in terms of what we should be aiming to achieve by the end of the placement. One of the main requirements for completion of the module is a portfolio comprising of 30 fully written cases from all of the main medical and surgical specialties. This required us to take a full history of the patients’ presenting complaints and to perform a complete examination.

Much to my surprise, the most difficult part for me was not taking the history or carrying out the examinations, but rather approaching patients on the wards. The full history and examination can take as long as 1-1.5 hours, especially for beginners, and I could think of hundreds of different things patients would rather do than talk to a nervous 3rd year medic. Most importantly, I thought that as a medical student there isn’t much that I can offer them compared to a doctor.  As it often goes, I was completely wrong. I must have greatly underestimated how boring lying in a hospital bed can be, because all the patients I went to see, including those acutely unwell, were more than happy to talk. Furthermore, I was frankly quite taken aback by their willingness to help medical students in their learning.

In the hindsight, it was silly of me to be nervous about approaching patients, yet it was one of the things I had to overcome. If I was to start again, I would just force myself to approach a couple of patients in the first few days without putting much emphasis on the history-taking and examination. That would take away the anxiety of approaching them and would allow me to focus on the clinical skills sooner.


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