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Medical school is more than practice problems

Kira Kopacz
Education
July 24, 2021
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It was the first day of my third year of medical school. I was assigned to an outpatient OB/GYN clinic. I woke up early, had only a coffee for breakfast that I would later regret, hesitantly wrapped a stethoscope around my neck, unsure if this specialty required such a tool, and punched the address into Google Maps. After almost 16 months of virtual med school, I was walking into uncharted territory. I was accustomed to sweatpants, hours of computer practice problems, and midday naps when I just couldn’t distinguish between the vasculitides. Today was my first day of real-world medicine.

I met my preceptor and sighed with relief within minutes. She was bubbly, enthusiastic, and above all else, amazing with bedside manners. She was my kind of person. We spent the morning going through the basics of the office, how to use a speculum, the intricacies of the online medical records, and most importantly, where the clinic’s bathrooms were located. Within an hour, we had a system together.

For every patient, the nurse would check if they were willing to be seen by a student. Once approved, I’d rehearse the questions I had been taught to ask during Zoom med school and knock on the door. With each encounter, I felt more confident, more like a doctor, and more like where I belonged. I was simply riding on an adrenaline rush fueled by history taking, hand hygiene, and introducing myself as a coveted third-year medical student.

After each encounter, my preceptor and I would head back to her office and discuss the patient before the nurse told us where the next patient was roomed. As my preceptor cheerily chatted while typing up the last patient’s progress note, her voice hushed, and her smile faded. She whispered that the next patient most likely will say no to a student in the room; her last pregnancy ended in a miscarriage at 13 weeks. She is here for a 13-week pregnancy check-up, and to top it all off, she’s a doctor. To our surprise, the nurse came in and told us the patient said yes to a medical student.

I knew the seriousness of the situation. When my preceptor entered the room ahead of me, I introduced myself and immediately thanked the doctor for allowing me to learn from this experience. Clearly nervous, the doctor gave me a weak smile and said, “You’re welcome. I know what it’s like to be in your shoes.” After some pleasantries, my preceptor grabbed the doppler to find the baby’s heartbeat. Silence. She moved it around the lower abdomen. Silence. She told me it could be tricky this early in the pregnancy to find a heartbeat. More silence. She turned to the shell-shocked doctor and told her to “stop your mind from going where it’s going.” The doctor nodded—utter silence. My preceptor told me to grab the ultrasound and hook it up. Trying to keep cool under pressure and also not admit to never using an ultrasound before, I wheeled the machine over, plugged it in, and thankfully found the power button quickly. With a graceful flick of her wrist and a generous squeeze of gel, my preceptor within seconds found the healthy, bouncing, baby girl in the black and white screen of the ultrasound. Instead of silence, a rush of relief tears came from the doctor. I tried to hide it, but I cried too.

That’s what was missing during Zoom med school: the human connection. No Google Meet session can teach you the vulnerability and emotional turmoil patients face. No online quiz can prepare you for medical uncertainty. And no simulated patient encounter can mimic the raw gut reaction a woman has when seeing her living baby that she once thought was in duress. I am forever grateful to that doctor for opening a window into her life for me. Now, I’ll always say “yes” when a nurse asks if a medical student can enter.

Kira Kopacz is a medical student.

Image credit: Shutterstock.com

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