What I think about during clinic - part one

1. Typing

"I hate not being able to type properly. It was such a disadvantage during the fellowship exams. I took double the time. Could hear all the other candidates tapping away..."

Touch typing should be compulsory, my classmate commented. The variety you see is amazing. Hunt and peck, with one or two fingers, index or with the middle finger. Or even touch typing with the left hand but pecking away with one finger on the right. Okay, if you're eighty and coming to the end of your career it's not so important. But for everyone else in the practice (doctors, nurses, receptionists) this should be part of professional development. Think of all that time you can save.

At least medical students can be helpful in something, eh? Typing out notes as the clinicians dictate, or helping a nurse to discover, with much delight, that keyboard shortcuts exist for copy, paste, underlining, and bolding text.

2. Consent

Being a female student, I didn't have a single patient refuse consent for a long time, even during the rather awkward gynaecology clinics. But there seems to be an average of one patient each day at this clinic who refuses to see students simply on a whim. Or the patient who comes to the appointment half an hour late and writes on the form:

"Student okay, but wants doctor to do everything." For a straightforward cough and cold. I don't think the person realises that although less experienced, students are taught to be thorough. And even the doctor is more likely to take less shortcuts, and think properly about your case, when he or she is teaching.

I'm happy to sip hot tea and milk in the tea room, munching on an apple or the occasional pumpkin seed, surfing the net on my phone. But whilst waiting, I also began to form strong opinions about consent in regards to seeing medical students.

Firstly, it all depends on how consent is obtained. Some sessions I get a run of several patients refusing consent and I can't help wonder what the reception staff is saying to the patient. No wonder some of my male classmates had difficulties getting into delivery suite when the midwife, with a frown, said tentatively:

"Well, there is this male medical student... would it be okay if he attends the birth? You can say no, it's okay to say no..."

Scenario one - written consent needs to be obtained for every patient (as it is in this practice). Scenario two - displaying clear signs in the waiting rooms that this is a practice with medical students, and if patients have an issue with having one in their consultation, they can speak to reception to opt out. I'm sure the number of patients who say "no" would differ. A lot.

Coming to the end of my time as a student, I can't help think, well in a few months time I can't refuse to see you in the emergency department, in outpatients clinic, simply because I don't feel like it. Certainly, a patient should be able to opt out of seeing the student if there is a legitimate reason - for example, if the student was a family friend and the patient needed a sensitive examination, or wanted to discuss serious mental health issues. Or if they need to be somewhere by a certain time, and can't be in with the student for half an hour before the doctor sees them. That's okay. But it shouldn't be for no reason.