MEDICAL STUDENT TRANSITION COURSE Professionalism in the Clinical Environment ANTHONY A. MEYER, MD, PHD CHAIRMAN, DEPARTMENT OF SURGERY UNIVERSITY OF NORTH CAROLINA

Beginning Clinical Clerkships Remarkable Opportunity New Challenge Unprecedented Responsibility Start of Your Clinical Career

Change In Focus Up to now – Focus has been on the student Clinical Care – Focus is on the patient You are part of a team to help the patient – the patient is not here for you to learn

Clinical Clerkship Service Rotations Each service is different Patient mix and diseases Number and level of residents Number of faculty and clinical activity Workload Time schedule Service structure developed to meet patient needs and other requirements

General Learning Goals for Clerkship Acquisition of knowledge and skills Integration of knowledge and skills Application of knowledge and skills Additional Learning Goals  Patient Interaction (active participation in care and responsibility)  Staff Interaction (roles & respect)  Colleague, Resident and Faculty Interaction (collaboration & respect)

Patient Interaction Early on, you may be uncomfortable Your patients will have varying comfort with students A few patients may not want student involvement Many patients are frightened, have pain, are in a new experience Don’t personalize negative experiences Try to put yourself in the patient’s situation Ask yourself, what if it was my ________

Resident Interaction Closest to you in age, background and experience You will learn much from them More advanced than you, but still in training Residents’ primary responsibilities are their education and patient care If you have concerns, speak with the clerkship director

Hospital Staff Interaction Respect all people who participate directly and indirectly in the care of patients You can learn a great deal from the hospital staff Remember that competence, intelligence and contribution to patient care are not determined by academic degree Realize that you have a common goal – providing the best possible patient care

Faculty Interaction All are interested in teaching but have different roles and styles Varying other responsibilities Different schedules of patient care Different stages in their careers Don’t hesitate to approach them If you have concerns, speak to the clerkship director or department chair

3 rd Year Medical Students Responsibilities & Roles Different teams have different responsibilities for students You start as the least experienced person on the team Find out your responsibilities (some explained, some assumed) Learn and perform your role before you start another If it’s your responsibility, make sure it is accomplished Accepting responsibility for patient care is one of the first steps to being a physician

Feedback to Medical Students Variable in amount and form Comes from Faculty, residents, peers, and staff It is not always announced It’s not always verbal It is not always positive Use it to improve, not just to feel good Don’t hesitate to ask for feedback

Traditions in Medicine Traditions are present in all societies and professions Contribute to professionalism and ethics Often hard to understand Respect traditions, but remember the patient is always most important It is your activity and commitment over a career that will create new traditions

Professionalism Dedication to others Commitment to excellence Performance standards Behavior standards Respect for all Confidentiality

How should I Act? What should I do? Treat patients like you want your family members treated Show respect, courtesy and civility toward everyone Observe and learn from others Look and act like a physician If you’re not sure, ask Seek out opportunities to help Enjoy what you are doing

Important Things To Consider Patient care and learning are not “like on the TV medical shows” Medicine is a humbling profession Be part of a patient care team Allow yourself to feel Act professionally Learn from everything and everyone, even when not being taught

Transition to Clerkship - SUMMARY - ExcitingChallengingDemanding Period of incredible growth Opportunity to be part of one the greatest professions