
“Every patient carries her or his own doctor inside.”
~ Albert Schweitzer
learn. do. teach.
we are finally on step 2.
this week, we were graded on our first hands-on patient-interactive exam. we had to dress up in professional clothes and wear a white coat and drape a stethoscope around our neck and stand in front of someone sitting on an examining table as if we might be able to figure out what’s wrong with them. i played the doctor once and the patient twice and found both roles to be equally educational.
here’s an (abbreviated) overview of what you’ve probably seen in your doctor’s office a zillion times.
introduction: name, medical student, purpose, wash hands
vital signs: ask height and weight for BMI, take pulse & blood pressure
skin: general survey, colour, temperature, moisture, turgor, etc
head: hair, scalp, temporal arteries, masseter muscle, temporomandibular joint
eyes: eyebrows, eyelashes, conjunctiva, sclera, pupils, optic disc, visual acuity
ears: mastoid process, auricle, lobe, canal, tympanic membrane, hearing acuity
nose: septum, inferior turbinate
mouth: lips, teeth, gums, tongue, parotid & sublingual glands, uvula (“ahhh”)
neck: lymph nodes, trachea, thymus
chest: inspect, palpate, percuss, auscultate
the exam ended with listening to the lungs in 6 spots on the anterior chest. we haven’t learned anything beyond that yet, so it sort of felt like examining half a person.
oh wait. it was.
i have to say, this sort of test anxiety is different than the palpitations you can get filing into a classroom and staring at a scoring sheet. no matter how well you feel you know the material, the fact that someone is staring over your shoulder is more than a bit unnerving.
but after several years of an undergrad career where you are just a number in a lecture hall, it’s really nice to get immediate and detailed feedback on your personal performance.
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note: the photo is of my grandpa’s gear from his med school days in the early 50′s. i didn’t bring any of it down with me because i was worried about transit damage, but plan to replace the stethoscope tubing when i get back home and will hopefully be able to use it. right now i have a Littmann scope, Omron sphygomanometer and ADC pocket otoscope opthalmoscope set. all of my equipment was delivered by the wonderful marvelous Kev when he came to visit in August. i recommend each name brand and prefer ADC over some of the other oto-opthalmo sets that i have seen that look particularly complicated.