Only a handful of doctors are actually interested in teaching us during clinical postings. The rest of them ignore us.
Let that sink in.
This used to piss me off initially during my 2nd year. I used to go to the wards with hopes of seeing a huge number of cases every day, and even make a diagnosis or two.
I even used to think that they’d let us do a few surgeries during General Surgery postings. Lol.
But postings are way different.
So what do we do in postings (no matter what the department)?
History. History. History.
I cannot emphasize how important this simple thing is.
It’s the history which forms the entire basis of the clinical diagnosis. A little change in patient’s history and the entire diagnosis comes crashing down.
Take for example: Fever.
You may think there’s nothing much about fever, right? Give a tablet of Paracetamol and we’re done.
Nope.
There are hundreds of differential diagnoses that you can make for fever. That’s when a proper history comes to the rescue.
Fever along with coughs and night sweats? Suspect something like tuberculosis.
Fever along with rashes? The patient is a child? Suspect something like measles/chicken pox.
Intermittent fever along with chills? Suspect something like malaria.
And the list goes on.
All said and done, who’s gonna teach us all this in the clinics?
Hehe. No one.
You are supposed to read all this theoretical stuff by yourself and then come to the clinics. The doctors there can only guide you with the process of reaching a diagnosis.
But they are never gonna spoon feed you.
That’s what adult education is about, I guess.
In a way, it’s good. It’s frustrating, but it’s good. We learn to implement all that we have learnt in our theory classes onto the real world.
Well, obviously we’re also taught how to clinically examine the patient, but it is secondary to the history.
So the next time you meet an MBBS student, try not to ask him/her about any medical condition of your relative. We might be as clueless as you are.
Ask us that once we get the “Dr” tag. We’ll happily listen to you then.
Though obviously not for free. 🙂
Signing off,