Not bunking off was the best decision I have made
Take a step outside your comfort zone
At some point every medical student will be tempted to leave a clinical placement early. Why loiter around the hospital ward or in a doctor’s office wasting your time when you could be doing something more productive, such as studying or getting some exercise? It’s not like you are of any use to the medical team—if anything you’re a burden. Well, that was my view before I decided to spend an extra hour at the hospital where I was working during a recent clinical attachment.
The scene was familiar: it was a mundane weekend on call and I felt like I was being ignored by the acute admissions team. It was fast approaching lunchtime. I had been on the morning ward round and signed the attendance register. Nothing was stopping me edging towards the exit door.
But a thought struck me: as medical students, a substantial amount of our fees go towards learning in clinical settings, and we should try to make the most of these opportunities. Although a lot of our time on the wards is self directed, we are in a unique position where we can pursue our interests and fill gaps in our experience and knowledge. I decided to give the hospital setting one more chance.
I wandered down to the emergency department to see if there was anything I could get involved in. Nurses and doctors in front of me were working quickly. I waited for the right opportunity to introduce myself, but before I could open my mouth a voice asked, “Are you a medical student?” I had barely said yes before the registrar interjected, “Okay, I’m Dr X, would you be able to support us with the incoming trauma call?” Before I knew it I was in a “hi vis” jacket and on my way to the helicopter landing pad to observe the rapid transfer of an emergency trauma call.
The patient had sustained critical injuries to the head. I was given the job of recording in the medical notes what happened in the trauma room. This included documenting the drugs given to the patient, examination findings, and medical interventions such as airway management. Record keeping is crucial in any hospital setting, but in a trauma room everything happens so fast it is imperative that accurate information is noted. It was a challenge to listen carefully to each member of the team and note down concisely the important clinical points. I used diagrams to explain examination findings, which helped me keep up with the activity in front of me.
While in the trauma room I observed the role of every member of the team. The consultant managed the ABCDE approach, the surgeon performed an abdominal examination, the nurse established peripheral venous access, and the registrar led the team to ensure the best care for the patient. Many of the skills we learn at medical school were demonstrated in a short space of time, and their importance in saving the patient now became obvious to me.
The patient stabilised and was transferred to have computed tomography (CT). Satisfied my job was done, I loosened the velcro on my jacket, but the registrar told me to “follow the patient through to the CT scan and we will catch up there.” The scan showed widespread damage to the brain and the patient had successful emergency surgery and was transferred to the intensive care unit.
After the patient was scanned I was asked by the acute medicine registrar to return to the emergency department. He ran through the experience with me and taught me more about the medicine behind the case. We discussed the CT scan, the pathology of brain haemorrhage, and the neurological examination of the patient. He thanked me for my contribution. As I was leaving, the nurse in charge approached me and explained how the notes I had made would be essential in the care of the patient while in the intensive care unit.
This experience has changed my approach to clinical placements. It made me feel part of the team and that I was appreciated for my contribution. Now, I seek out opportunities to get involved with any teams that might need my assistance. Don’t discount spending an extra hour on placement or taking a step outside your comfort zone. As medical students we have the freedom to walk between medical, imaging, or surgical departments within the hospital—there’s no excuse to say there’s nothing to do.Kishan Patel, fourth year medical student
1University of Sheffield, UK
Correspondence to: email@example.com
Acknowledgment: I would like to thank Dmitriy Starostin for his help with this article.
Competing interests: None declared.
Patient consent: patient anonymised.
Provenance and peer review: Not commissioned; not externally peer reviewed.
Cite this as: Student BMJ 2015;23:h5702