P = MD

What's P=MD, you ask? Well, "P" is short for "pass", and it's a general symbolic phrase for the concept that, in order to become a doctor, all you need is to pass your medical school classes. I've pretty much embraced this notion wholeheartedly (perhaps a little too much so), and I'm entering my medical school experience with a minimal-stress, maximal-learning kind of attitude; I'm planning on just learning what I find fun, interesting, and useful, and hoping that information will carry me over the "P" mark. I'm not gunnin' for any Top __ status here, folks. I'm pretty much just here for the ride.

Which makes for a very good time. I have to say, I'm having a freakin' blast in school. I find everything interesting, I even enjoy studying and reading, and, most of all, I find that by being interested in the material (rather than begrudgingly learning it out of obligation), I am able to process it better. I haven't actually spent any time at a library yet, and the time I have spent studying for hours has been with cool people at cool places. In effect, it's always some degree of fun. There's a huge exam on Monday that everyone's kinda going crazy about. I've been sick and therefore haven't studied all week, but my low-stress attitude has left me pretty comfortable with the situation (enough so that after I'm done blogging, I'll take a shower and go to bed early).

Anyway, since I have these silly ambitions of being a medical journalist as a "side" career, I've decided to sort of document my experiences in school, how they made me feel, what they say about medicine as a profession and culture, etc. I love comments, so comment away!


Today, I had my second Introduction to Medical Interviewing course. This is a course in which a group of 4-5 students are paired with a moderator and a standardized patient. Each student takes her turn interviewing the patient as the other students (and faculty facilitator) watch. At the end of the interview, the student is given feedback from all members involved. The learning is done through a process of positive reinforcement and imitation; each student tells the interviewer what she did well, and learn from those successful skills. All in all, it is a helpful if nerve-rattling experience.

Standardized patients are actors who are trained to be "fake" patients. They are a crucial component of medical training; standardized patients allow student doctors to "mess up", if you will, before they come across real patients in real situation, where it "matters". Now, you can imagine how different all doctor-patient interviews could end up: a doctor could ask anything from your family history to your sexual history to the accident you had when you were three years old. A doctor could ask you what type of exercise you do everyday, and ask you to elaborate. He could ask you where your kids attend school, and whether you like their teachers. None of this detailed information is supplied to the standardized patients; they're only given a condition and some peripheral imformation relevant to their "fake" condition. Everything else has to be improvised, yet remain realistic within the scenario.

Needless to say, these standardized patients are excellent actors. In fact, it's very easy (and equally important) to get pulled into the realistic nature of the situation. When I'm interviewing my patient, I allow myself to believe that I'm the (student) doctor who is seeing a woman with a real abdominal pain and a real concern for her health. In letting myself "feel" that it's real, I've become more and more comfortable in the role of the questioning, concerned health care provider. It's a role that feels strange and new, but good. Building rapport with patients is not easy, but it's such a delightful experience when it goes right. And it's reassuring that we get so much practice. I hope all schools will start putting more emphasis on this interpersonal aspect of medicine soon. I can't imagine how awkward and tactless I'd be without the experiences I'm gaining now.