I never thought I’d be writing something on this subject. Believe me, I’m the last person that should be writing something like this. I’m talking about clinical postings in hospitals which happen every morning for 3-4 hours since coming to second year. Two and a half years have passed since these things started and I wonder what have I done all that time. Now that I’m in final year, when we really need to utilise this time as there will be a practical exam in this, I realise that I’ve been wasting almost every morning of college by not doing anything all this time. What could have been the problem you ask?
Well firstly, the impulse every morning was not to go to the hospital as “nothing much happens” and “there is no use going”. Attendance was also not that important. Now I realise that these were just excuses and I wouldn’t have made them if I didn’t want to do something else. The same time could be spent watching some cool show or movie or do some or the other more interesting thing. Anyhow, I didn’t let this affect me much. I convinced myself every time that there is a proper time for everything and that even is you learn one thing today in the hospital then you’ve done a good job. So overall, my attendance was low but not very low, better than the average. I just used to go a little late every time, without missing anything important.
The second thing- after reaching the hospital, not being proactive in the wards. Each student could see any number of cases he wanted. Even with all this, I couldn’t make much use of it. I’ve never found History-taking a very interesting nor a very useful thing. I always thought of it as unnecessary troubling of the patient. Any good student or teacher would be agitated if he reads this. Yeah it’s true that it’s important, but only when it’s done in the right way. And the only right way to do it was to know why you’re doing it and what is the relevance of every question that you trouble the patient with. Coming to Clinical Examination, that needs even more knowledge of the subject. There were two problems in this- either we didn’t know properly what are we supposed to do and why or there were so many students examining a single patient that it was hard to do it properly or just plain not worth the trouble. Now I wonder why did we all crowd around a single patient? Probably because we were afraid to take a case alone as we don’t know much. Probably our combined knowledge will help us get through. Furthermore, even though patients are plenty, those with classical presentation or those with conditions which are academically relevant to us are not so common.
Was there no one to teach you? – you ask. Well that’s the third problem. I do feel that we students are the one being wronged here. It’s that no one in the departments cares about you. Hardly anyone is interested in teaching you. There was no proper schedule of teaching nor fixed teachers to teach a subject. I don’t know whether this is the condition of only our college or in others too. Anyhow, we managed somehow most of the times. You can try and find someone who’ll teach you.
So now that I’ve told about all the problems I had, it’s time to decide what to do, if you want to avoid the earlier mistakes and make the most of what remaining time you have. Here are a few things I learnt from my experience :-
1.Get up, dress up and show up every day, regardless of what is happening or what will happen. It’s important to be right in principle. They say its better to regret something you did rather than regret something you didn’t do.
2.As clichéd or impractical it sounds, read and be prepared for whatever case you’re going to take BEFORE you take it. The ideal situation would be to become perfect in a particular case and then see the patient. Of course, we are not perfect. All we can do is try to strike the right balance between the patient and the book. A little bit of both here and there. It’ll enable you to properly take the case and also reinforce what you have read by seeing it live in a patient.
3.You need to “practice” everything. That is – do it repeatedly. As much as you get the chance to do. For example, eliciting a reflex looks so simple when you see people doing it, but you’ll realise what it is when you try. (Btw I only recently came to know that you’re supposed to look at the muscle twitch in a tendon reflex, not the movement of the limb).
4.Find someone to answer your questions, probably show you some procedures, and present the case to the person. Bear the torture of a hundred mistakes getting pointed out in your presentation. Just bear it. Due to some reason, they think that while pointing out mistakes, they are teaching you. But the difference lies in the way it’s done. Most of the times it appears like they’re discouraging the student without them knowing it. Anyhow, forgive the teachers if they’re being rude. They probably don’t understand a student’s psychology and are probably just doing their teaching job unwillingly as a compulsion.If you were an ideal student and had read before taking the case then it will help you a lot at this stage.
5.Take notes of whatever is being told. Try to write everything that you can, as neatly and systematically as possible in a notebook that you’ll not throw away somewhere but will see again. This stuff is not usually given as such in the textbooks but it is very useful in viva, theory as well as answering other professors’ questions. Think of it as a secret book that all the professors have, from which book alone they accept answers, but students have no way of accessing it except in a few instances where the professors use it for teaching.
6.Don’t tell yourself that I’ll go home and read all about it. It is irrelevant whether you’ll read it later or not. Your job is to utilise this time as much as possible. It’s best to assume that you won’t be able to, so finish whatever you can here and now.
7.Discuss stuff with your fellow students. You’re lucky if you have someone with you who knows more than you. This is a much simpler and much more effective way of learning things than doing that from a book. It’s like the difference between eating and digesting something (reading) or just taking IV glucose (learning from others). They have processed everything for you.
This post became quite long. I didn’t plan to write this, it was just an impulse. As someone said- “I write to know what I think.” (Joan Didion). Hope this makes things clear for me as well as help you the reader. Writing makes an exact man they say (Francis Bacon). I sure hope to be so.
