What are you waiting for? Get out there and see some patients.

The problem

• It seems that nowadays medicine is being taught in classrooms, on actors and by videos.
• This is lovely, safe and hopelessly artificial.
• Back in the old days we actually saw real patients
• Today, students appear frightened and intimidated from venturing from the medical school and onto the wards and clinics.
• Common excuses are that no-one has organised it for you or they weren't supposed to be 'rostered' there.

8 reasons why you should

• You have a $50000 ticket to the wards called your HECS fee
• You wear a hospital badge that says 'Medical Student'
• Nothing you learn makes any sense until you see it in real life
• If you don't see it, you will forget it (and need to relearn it)
• Most patients actually like students because they are more thorough and less likely to cut them off
• No patient ever died from a clinical assessment
• You need to learn how to polish your history and examination skills until they are second nature so you can devote your thoughts to actually making a diagnosis and management plan.

How do you go about it

Example - coronary artery disease

• Dress as if you were a doctor
• Wear your badge
• Throw a stethescope around your neck (even a cheapie) to complete the picture
• Go to the cardiology ward (ask at the information desk at the front entrance if you don't know where)
• Ask a nurse at the station for the CSC
• Ask the CSC for a nice patient admitted with angina that will talk to you. Ask if you can have a look at the notes (take them but don't read them just yet).
• Ask the nurse if it would be OK for you to page the cardiology registrar for an interesting patient to talk to or examine. Get her pager number and find out how to page them
• Page the registrar and stand next to the phone. Don't leave unless there is no answer for 5 minutes. Repeat x 1.
• Introduce yourself and ask nicely if there are any patients with a good history for coronary artery disease. Ask if the registrar is also available later to hear you present the case.
• Introduce yourself to the patient and assess them.
• After your assessment look in the case notes at the admission and progress notes. See if there was anything you missed in the history. Take note of this.
• Return notes to the appropriate place in the nurses station
• Re-page the cardiology registrar and say you are ready to present the case to her and when and where you should meet her.
• Present the case.
• Ask if there was anything to improve the presentation.
• Later that day spend 20 minutes revising your notes and refer to your textbooks about it.

see Medical student ward orientation guide