There are a few clinical scenarios that stand out to me from my undergraduate medical education. I completed a combined MD/MPH program, and I remember coming back from the year of public health, inserted between years two and three of medical school, feeling rusty and often in the way. One conversation I’ll always remember is one I overheard between an attending on my family medicine rotation (my first rotation of my third year) and one of his patients, a woman in her sixties.
“I read the medical student’s note from your visit yesterday and noticed she mentioned you had some vaginal bleeding. Is that accurate?” the attending asked, pausing to listen to the response, which I gathered was a confirmation.
“OK. Generally, when post-menopausal women have bleeding, there are things we recommend to ensure there isn’t anything harmful.”
I don’t know the outcome of that encounter, whether the patient received the endometrial biopsy, and if so, what it revealed. What I took away from that encounter was how the medical student, whose identity was unknown to me, could have such a significant impact on information gathering and patient care.
In medicine, we commonly use the term “Swiss cheese model” to demonstrate how each member of the team has gaps in different places, and unless those empty spaces line up, important information may be missed. However, as a medical student, it’s sometimes hard to see your own utility when you may feel that your contribution is minimal. That’s exactly how I felt.
As I progressed in my training as a resident, fellow, and now as a new attending, I began to see the role medical students play from a different perspective. During my residency, one of the students on our team developed a relationship with a patient who required regular hospital admission. In the afternoons, the student would check on this patient and sometimes play video games with them when the patient needed a worthy opponent. The trusting relationship they built helped the patient feel comfortable sharing his experiences and symptoms with the student, enabling our team to provide optimal care. This patient recognized our team medical student as a trusted individual and would request the student’s return during subsequent admissions.
As a fellow and now an attending in adolescent medicine, I have found that although students are usually new to our content area, they are valued members of the team. While they may not be experts in adolescent medicine, they are highly invested in their patients. They spend time with the patients they’re following, listen to their concerns, offer encouragement, and help them feel heard. In the process, they learn about illnesses directly from patients and families.
Therefore, when we enter a patient’s room to round and introduce ourselves, I correct anyone who introduces themselves as “just the medical student.” If you are a medical student, you are an important part of our team. You have value, and your contribution is appreciated. There is nothing “just” about it.
Nicole Cifra is an adolescent medicine physician.
