Do Med Students get hands on experience by experiencing it or watching?

[Edge]

Out of curiosity, do medical students actually perform simple procedures such as a rectal exam for instance, or do they just watch the procedures?

[rmorelan]

Out of curiosity, do medical students actually perform simple produces such as a rectal exam for instance, or do they just watch the procedures?

 

Both - you wind up doing more and more procedures as time goes on and you develop your skills. There is also formal systematic hands on instruction for all the physical examination skills.

[leviathan]

Hopefully by end of medical school you should get the chance to have done chest tubes, central lines (at least femorals), thoracentesis, intubations and other procedures. But I think it depends on where you go to school and how confident they are in you.

[ploughboy]

Out of curiosity, do medical students actually perform simple procedures such as a rectal exam for instance, or do they just watch the procedures?

 

Looking forward to doing a bunch of DREs, are you?

 

Most schools make you track your procedures, but it's a bare minimum. At UWO a couple of years ago, the minimum requirements were:

 

ETT - 2

Newborn exam - 3

Foley - 3M 3F

Fracture reduction - 2

IV - 3

NG - 3

Pelvic - 3

Suturing - 3

Vaginal delivery - 1

 

Along with "softer" things like "communicate with family" (10) "mental status exam" (3) and "verbal summary of patient" (10).

 

Like Levi said, it depends on where you're working and your attitude. Most people do a lot more (unless the're focusing on non-procedural specialties like psych or path).

 

As a med student I did a lot of intubations, started a bunch of IVs, did several paracenteces (paracentesises?), placed art lines, floated a Swan (best day ever!), did chest compressions, cardioverted, defibrillated. Oddly enough, I have yet to put in a chest tube (and likely won't get the chance until half-way through my R2 year).

 

Oh, and DREs. Far too many DREs.

[national]

chest tubes are more of a by-product of the city you're in, the amount of trauma, and just your general karma. unless you're on a thoracic surgery team.

 

central lines aren't SUPER common for med students either, though all it takes is asking.

 

there are very few procedures you won't be allowed to do, as long as you are sensible and have supervision.

 

and for the small stuff like rectals, suturing lacerations, etc. staff often get you to do these things because it saves them from having to do it.

[peachy]

Oh, and DREs. Far too many DREs.

Yeah. I think prostate clinic was my least favorite clinic in medical school...

[Edge]

Thanks for the replies guys, I can imagine how it must be unpleasant to perform certain procedures.

 

Is there any way to avoid those unpleasant procedures and only complete the minimum? I hear that in med school, the medical students of a given stream will usually be place in small groups that they will work together during their tenure in med school.

 

Is there someway to delegate task amongst members through games of chance before clinic? such as the one pulling the short straw or losing to loaded dices?

[Lactic Folly]

Striving to avoid certain procedures only makes sense if you are sure you will not need that skill in your future practice (keeping in mind that most people rotate through multiple areas during residency, when they have to work more independently).

 

As unpleasant as you might find a certain task, it will be worse if you do it incorrectly through lack of experience and have to repeat it, or worst of all, harm the patient..

[peachy]

I agree with Lactic Folly about it being a bad idea to avoid unpleasant procedures. The sooner you learn to do them, the sooner they become a routine part of your day.

 

Also, taking DREs as an example again, the only way to avoid being in situations where you must do them would be to avoid ever seeing a patient with potential or actual GI bleeding. You'd be missing out on an important area of learning.

 

As procedures become more specialized and more difficult, it becomes less important to do them. I've never put in a chest tube, for example, and this isn't going to be a problem for me in my career as a psychiatrist.