Although Dr. F asked for my goals during the preceptorship and was no doubt trained by my course coordinators in what I could and should be doing, my afternoons with her did not resemble a preceptorship at all.
We spent large chunks of time closeted in her office talking about spiritual things and her philosophy of medicine (very alternative). While spiritual things and alternative medicine are terrific, it grated on me to see time slip away when I knew that I should be seeing patients (or studying). Worse, the patient volume while I was there was very small--I only saw two patients this week, and that was representative of the past three sessions. Finally, I was not able to practice forming assessments and plans, since the patients I was seeing were being evaluated for federal disability and no treatment is ever given. Granted, she calls me in to show me pathology, like femoral bruits or xanthelasmas. But the primary purpose of the preceptorship is to hone H&P skills.
I tried several times to ask her whether I could see more patients. "I could go in and see this one while you see that one," I'd say, but she would gently coerce me to do what she wanted in an annoyingly nice way that she probably meant well. All of this made me really angry.
Upshot: I called the course coordinator and I'm being moved; I won't even talk to Dr. F again.
Ironically, we have a Professionalism class about "Communicating in Challenging Situations" on Monday. I was reading through the presentation just now, which articulated all the things that I experienced:
The Typical Physician [and, by extension, the med student] is...I wonder how a two-hour class hopes to teach us how to resolve such complicated problems. These are moments when I'm glad I went to TAC, where criticism of ideas happened daily and formal behavioral feedback (don rags) happened twice a year.
Conflict arises when...
- Compulsive [check]
- Perfectionist [check]
- Guilt prone [CHECK]
- Exaggerated sense of responsibility [check]
- Limited emotional expressiveness [check]
- Significant communication deficits [ouch]
- Perception that another person is blocking our goals [exactly what happened]
- Another person is not acknowledging or understanding our beliefs or values [definitely contributed]
- Different expectations about roles, resources or outcomes [the root of the problem]
I guess I'm no perfect communicator, but I trust that the rest of medical school and residency will shape me a lot.