Tuesday, September 25, 2012

First afternoon in first preceptorship

This post conforms to the blog rules.
My first afternoon in Dr. F's preceptorship gets mixed reviews. You may recall that it had a rocky start.

So, confession time: I really want to be a doctor. I want to put my stethoscope on people and ask them questions and think up some things that might be causing their problems! I want to get messy and make mistakes! My preceptor, Dr. F, has a different approach. She wants me to see a lot and transition slowly. So, I spent the bulk of my day shadowing, took one history, and performed zero physicals. That made me angry.

I admit, her approach may have been a result of the way I presented that one history. I know presentations are supposed to be brief recaps of longer interviews that a med student makes to a physician. This allows the physician to check the student's mental work: what did she think was important? What step did he take next? What is he thinking of for a differential diagnosis?

I boiled down the history too much, I'm afraid, and I left my preceptor with the idea that I hadn't taken a complete history. To my frustration, she did not ask me for more; instead, she went in and interviewed the patient again, obtaining the same set of details that I did and all the while interjecting meaningful injunctions to me about collecting details.

Ah, misunderstandings! How you art rife when there is a power disparity!

I hope next week is better.

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