Sunday, June 17, 2012

How to Make the Most of Shadowing.

Right so I'm in the mood for a tips post so today I will be discussing how to make the most of a shadowing opportunity. This is mainly aimed to those who aren't in medical school yet.

Let's point out the obvious issues of shadowing doctors when you aren't in medical school yet:
  • You can't do any clinical skills
  • Don't have much knowledge in medicine 
  • Daunting environment - very unfamiliar/disorientating 
  • Never really spoken to a patient before
Common problems that you share with medical students:
  • You get ignored
  • Can't do very much (depends on the placement/consultant)
So with the common problem of getting ignored...there isn't much you can do about it other than finding someone who won't mind having students around/is a good teacher. Not being able to do much is a universal problem. Fair enough some patients don't want to be handled by a student and there has been several times where I have found myself sitting in a corner like an old piece of furniture. It's just something we all have to accept.

Right so as a prospective medical student you want to get some experience and see what it is really like to be a doctor so you ask to shadow a doctor/consultant. So how do you make the most of it? Because you won't have much knowledge about the specialty, the best thing you can do is observe the key skills that a doctor needs. The main skills you'll notice are:
  • Communication skills
  • Empathy
  • Teamwork
Communication is probably the most important skill to have as a doctor. The profession involves a lot of talking to patients, but also the need to listen to the patients as well. Watch how the doctor talks to a patient. Listen to how he/she asks a question. Usually doctors start a consultation with open ended questions to allow a patient to elaborate why they are in clinic. Watch the rapport that the doctor establishes with the patient. The best way to get info from a patient is to get them to trust you so the first few seconds of a consultation is key. Don't dig your head too deep into the medicine. Just focus on the interaction between the doctor and the patient. Some of the consultants who I have been attached to describe it as an art form. Communication is literally needed everywhere. Communication is key in theatre, clinics, and on the wards. If you're fortunate enough to go onto the wards, take some time and talk to the patients. I took my first patient history 1 month into medical school and hardly knew any medicine at that time. Take a social history which involves asking the patient about how his/her medical condition has affected them. Try to find a patient with a chronic disease such as heart conditions. Find out how their condition has changed their lifestyle. This is a good way to practice your communication skills and creating good rapport with the patient. Plus most patients on the wards are really bored so most will welcome a nice lil chat.

Empathy...I've made a post about this not too long ago. Again another important skill and something you'll sometimes see. Talking and listening to a patient is one thing, but watch to see if the consultant shows a bit of empathy. Sometimes patients have a tough time with their medical condition and SOME consultants do take the time to empathize.

Being a doctor involves a lot of teamwork. It is certainly not a one-man job. In clinic, you'll probably have a nurse helping out. Just watch how the doctor and the nurse interact and how they have to be on the same page. Essentially the nurse keeps the clinic running smoothly and on time. You'll probably see more teamwork in the operating theatre. There is always about 6-8 people in an operating theatre so again stressing the importance of communication skills and teamwork skills. Sometimes the consultant may invite you to a MDT meeting (multidisciplinary team meeting). There will be microbiologists, radiologists, surgeons, physicians, nurses, etc all sitting in one meeting to discuss complex cases. Not only do you have to get along with people in your own specialty, but you'll have to get along with people in other specialties. So essentially the care of a patient isn't just in one person's hands...but in many many other people's hands. If you can, take the time to appreciate this as when I first started out in medicine I didn't expect THAT many people to be involved in a patient's care. It was actually surprising and quite amazing how people manage to stay organized and not mix things up (but it does happen from time to time).

Oh and if you really don't know what's going on...best thing to do is just smile and look interested. No one wants a grumpy/tired/not interested student around them. If a doctor sees that you're interested then he/she will be more willing to teach. I've tested this so this is based on first hand experience. Recently in my last orthopaedic attachment...I was falling asleep in clinic (due to jet lag) and my consultant hardly said anything to me or really taught me anything. He just left me alone. Next clinic...got over my jet lag...more keen...leaning forward and looking interested - learned loads. My consultant taught me so much and he seemed to enjoy my company as I was interacting with the patients and with him as well.

Another tip is that if you find yourself on the wards and no one to follow - go find the junior doctors. They know what it is like to be a student as it is still fresh in their minds and they'll probably be able to sympathize and show you some interesting things suited for your level. I've encountered prospective medical students in the hospital before and don't be shy and just ask for help. For me, I'll always be happy to help unless I'm busy. Same goes with junior doctors/doctors of any level. As long as they aren't doing something really important/look really busy, just introduce yourself and ask em if they can show you around/teach. Just make sure they know you're not a medical student and just want to get a taste of what it is like to be a doctor. Some might even get a break and sit down with you and tell you what their day is usually like.

Good luck and I hope this post helped!

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