MEDICAL STUDENT MEDICAL STUDENT TRANSITION COURSETRANSITION COURSE

Professionalism in the Professionalism in the Clinical EnvironmentClinical Environment

ANTHONY A. MEYER, MD, PHDANTHONY A. MEYER, MD, PHDCHAIRMAN, DEPARTMENT OF SURGERYCHAIRMAN, DEPARTMENT OF SURGERY

UNIVERSITY OF NORTH CAROLINAUNIVERSITY OF NORTH CAROLINA

Beginning Clinical ClerkshipsBeginning Clinical Clerkships

Remarkable OpportunityRemarkable Opportunity

New ChallengeNew Challenge

Unprecedented ResponsibilityUnprecedented Responsibility

Start of Your Clinical CareerStart of Your Clinical Career

Change In FocusChange In Focus

Up to now – Focus has been on the Up to now – Focus has been on the studentstudent

Clinical Care – Focus is on the Clinical Care – Focus is on the patientpatient

You are part of a team to help the You are part of a team to help the patient – the patient is not here for patient – the patient is not here for you to learnyou to learn

Clinical Clerkship Service RotationsClinical Clerkship Service Rotations

Each service is differentEach service is different

Patient mix and diseasesPatient mix and diseasesNumber and level of residentsNumber and level of residentsNumber of faculty and clinical activityNumber of faculty and clinical activityWorkloadWorkloadTime scheduleTime schedule

Service structure developed to meet Service structure developed to meet patient needs and other requirementspatient needs and other requirements

General Learning Goals General Learning Goals for Clerkshipfor Clerkship

Acquisition of knowledge and skillsAcquisition of knowledge and skillsIntegration of knowledge and skillsIntegration of knowledge and skillsApplication of knowledge and skillsApplication of knowledge and skills

Additional Learning GoalsAdditional Learning Goals Patient Interaction (active participation in care Patient Interaction (active participation in care

and responsibility)and responsibility) Staff Interaction (roles & respect)Staff Interaction (roles & respect) Colleague, Resident and Faculty Interaction Colleague, Resident and Faculty Interaction

(collaboration & respect)(collaboration & respect)

Patient InteractionPatient Interaction

Early on, you may be uncomfortableEarly on, you may be uncomfortableYour patients will have varying comfort with Your patients will have varying comfort with studentsstudentsA few patients may not want student A few patients may not want student involvementinvolvementMany patients are frightened, have pain, are in a Many patients are frightened, have pain, are in a new experiencenew experienceDon’t personalize negative experiencesDon’t personalize negative experiencesTry to put yourself in the patient’s situationTry to put yourself in the patient’s situationAsk yourself, what if it was my ________Ask yourself, what if it was my ________

Resident InteractionResident Interaction

Closest to you in age, background and Closest to you in age, background and experienceexperienceYou will learn much from themYou will learn much from themMore advanced than you, but still in More advanced than you, but still in trainingtrainingResidents’ primary responsibilities are Residents’ primary responsibilities are their education and patient caretheir education and patient careIf you have concerns, speak with the If you have concerns, speak with the clerkship director clerkship director

Hospital Staff InteractionHospital Staff Interaction

Respect all people who participate directly Respect all people who participate directly and indirectly in the care of patientsand indirectly in the care of patientsYou can learn a great deal from the You can learn a great deal from the hospital staffhospital staffRemember that competence, intelligence Remember that competence, intelligence and contribution to patient care are not and contribution to patient care are not determined by academic degreedetermined by academic degreeRealize that you have a common goal – Realize that you have a common goal – providing the best possible patient careproviding the best possible patient care

Faculty InteractionFaculty Interaction

All are interested in teaching but have All are interested in teaching but have different roles and stylesdifferent roles and styles

Varying other responsibilitiesVarying other responsibilities

Different schedules of patient careDifferent schedules of patient care

Different stages in their careersDifferent stages in their careers

Don’t hesitate to approach themDon’t hesitate to approach them

If you have concerns, speak to the If you have concerns, speak to the clerkship director or department chairclerkship director or department chair

33rdrd Year Medical Students Year Medical StudentsResponsibilities & RolesResponsibilities & Roles

Different teams have different responsibilities for Different teams have different responsibilities for studentsstudentsYou start as the least experienced person on the You start as the least experienced person on the teamteamFind out your responsibilities (some explained, some Find out your responsibilities (some explained, some assumed)assumed)Learn and perform your role before you start Learn and perform your role before you start anotheranotherIf it’s your responsibility, make sure it is If it’s your responsibility, make sure it is accomplishedaccomplishedAccepting responsibility for patient care is one of the Accepting responsibility for patient care is one of the first steps to being a physicianfirst steps to being a physician

FeedbackFeedback to Medical Studentsto Medical Students

Variable in amount and formVariable in amount and form

Comes from Faculty, residents, peers, and staffComes from Faculty, residents, peers, and staff

It is not always announcedIt is not always announced

It’s not always verbalIt’s not always verbal

It is not always positiveIt is not always positive

Use it to improve, not just to feel goodUse it to improve, not just to feel good

Don’t hesitate to ask for feedbackDon’t hesitate to ask for feedback

Traditions in MedicineTraditions in Medicine

Traditions are present in all societies and professionsTraditions are present in all societies and professions

Contribute to professionalism and ethicsContribute to professionalism and ethics

Often hard to understandOften hard to understand

Respect traditions, but remember the patient is Respect traditions, but remember the patient is always most importantalways most important

It is your activity and commitment over a career that It is your activity and commitment over a career that will create new traditionswill create new traditions

ProfessionalismProfessionalism

Dedication to othersDedication to others

Commitment to excellenceCommitment to excellence

Performance standardsPerformance standards

Behavior standardsBehavior standards

Respect for allRespect for all

ConfidentialityConfidentiality

How should I Act? How should I Act? What should I do?What should I do?

Treat patients like you want your family Treat patients like you want your family members treatedmembers treated

Show respect, courtesy and civility toward Show respect, courtesy and civility toward everyoneeveryone

Observe and learn from othersObserve and learn from others

Look and act like a physicianLook and act like a physician

If you’re not sure, askIf you’re not sure, ask

Seek out opportunities to helpSeek out opportunities to help

Enjoy what you are doingEnjoy what you are doing

Important Things To ConsiderImportant Things To Consider

Patient care and learning are not Patient care and learning are not “like on the TV medical shows”“like on the TV medical shows”

Medicine is a humbling professionMedicine is a humbling profession

Be part of a patient care teamBe part of a patient care team

Allow yourself to feelAllow yourself to feel

Act professionallyAct professionally

Learn from everything and everyone, Learn from everything and everyone, even when not being taughteven when not being taught

Transition to ClerkshipTransition to Clerkship- SUMMARY -- SUMMARY -

ExcitingExciting

ChallengingChallenging

DemandingDemanding

Period of incredible growthPeriod of incredible growth

Opportunity to be part of one Opportunity to be part of one the greatest professionsthe greatest professions