In your Clinical Medicine class you will be able to talk to real patients starting next week. They will know you are first year students and will not expect you to be physicians. You will learn that you can take a good medical history from a patient even if you have no clue what to do with the information. This experience highlights the importance of the human qualities you bring to the bedside because you won’t have any medical qualifications at that time.
Posts Tagged ‘medical education’
Letter to New Medical Students (4)
Thursday, January 28th, 2010Letter to New Medical Students (3)
Wednesday, January 27th, 2010You can begin learning to care for patients by first caring for each other. There will be times when a classmate can relate to your life better than anyone else. To help you get to know each other we will give each of you a booklet containing, for each class member, their name and photograph, home town, undergraduate institution and something personal that they offered to share.
Letter to New Medical Students (2)
Tuesday, January 26th, 2010The amount of factual material to be presented to you in the next four years is, for practical purposes, infinite. Even eliminating your need for spouses, friends, family, recreation, hobbies, sleeping, eating, urination and defecation will not give you enough time to learn it all though some have tried. Therefore you must constantly draw and redraw a line between your medical life and the rest of your life. A medical career is a constant search for balance between these two worlds and your search for that balance will begin soon.
Letter to New Medical Students (1)
Monday, January 25th, 2010I teach medical students occasionally, most intensely in a class called the Healer’s Art that was developed by Rachel Remen, MD. These experiences led me to ideas about education that are presented below as a letter (or speech) to new students on the first day of medical school. I have never sent this particular letter (or given the speech) but perhaps someday…
Empathy and the Mind-Body Problem (6)
Tuesday, January 19th, 2010At a high school track meet some years ago, one of my sons high-jumped over a bar set at 6’10” (2.08m). If I had spent my entire youth with the best high jump coach in the world I could not have come close to that. I remember telling my children that our abilities resemble Manhattan island, with some buildings reaching a great height and others much lower. (My ability in carpentry resembles a hole in the ground in that analogy.)
Kroenke & Mangelsdorff (2)
Friday, January 8th, 2010To continue discussion of the Kroenke & Mangelsdorff research*, let’s begin by looking at what became of all 567 symptoms (in 380 patients). For 2/3 of the symptoms, doctors did diagnostic testing or referred to a specialist. In the other 1/3, no evaluation was done beyond the initial visit. Treatment was recommended for only 55% of symptoms, and this took the form of a prescription in over ¾ of cases. There was nothing to suggest that anyone searched for hidden stresses linked to the symptoms (posts tagged with “Stress History” explain how this is done).
Mental Health Professionals and Physicians (Intro)
Thursday, December 3rd, 2009Millions of people who could benefit significantly from a few visits with a mental health professional never get the chance. This is because the psychosocial stresses they are coping with manifest primarily as physical symptoms. When they go to a medical office, diagnostic tests are normal because the stress causes no visible damage to the body. Most of the time, neither the physician nor the patient knows what to do next.
Adults who had Stress in Childhood (4)
Tuesday, December 1st, 2009The long-term effects of childhood stress impact relationships and mood in adults. The study* described in the last post surveyed 380 women who came to a general medical clinic. In addition to questions about abuse in childhood, patients were surveyed about whether they had ever experienced intimate-partner violence (IPV) and also about depression. (The vast majority of those who had experienced IPV were no longer in an abusive relationship.)
Adults who had Stress in Childhood (3)
Monday, November 30th, 2009Adult patients seen by primary care medical clinicians often are affected by stress in childhood. Recent evidence of this is a study of 380 women at a medical clinic at Oregon Health & Science University in Portland *. Their survey asked about physical or sexual childhood abuse and assessed the impact of these on physical symptoms.
Bringing Vision to the Blind Spot
Sunday, November 15th, 2009The good news is that hundreds of millions of people do not have to suffer needlessly from stress illness. The solution will take time and effort but what needs to be done is clear.
