Chapter 9 : Can I be a good clinician ( 4 )

9.4 How do I make full use of my clinical session in the clinic?

First, make sure that you are punctual. A five-minute delay to the clinic may mean that you may have missed an interesting case. Make sure to jot down all the cases that you see in the clinic. Try to ask the medical officer or lecturer about the case. If they are too busy to attend to you, note down the case and write down your doubt about the case. Clarify it during the tutorial session or any time you can get hold of the lecturer.

A very useful thing to do is to have a clinical notebook and jot down the learning point against every case that you have seen. This is a good way to ask the medical officers or lecturers with whom you see the case.

An illustration of a clinical notebook :

Date :                                                               Learning points / doubts

Case :

Diagnosis :

Important :

History                                                 Things to revise about this disease

Physical signs investigations                               - basic science

Treatments                                                       - clinical subjects

After the clinic, be sure to check up on the cases and read around the topic. Should there be any basic knowledge that is preventing you from fully understanding the case, ensure that you read about it. Most students find it a big chore having to revise the basic pre-clinical subjects. They do not realise that studying the subjects in order to understand the clinical features will have a tremendous impact on the understanding of the clinical subjects and remembering the pre-clinical subjects.

 

Anything that is understood in a logical manner by the application of the basic anatomy and physiology will be much consolidated and will stick in your mind for a long time.

An example in the ophthalmology clinic setting: seeing a patient with a dilated pupil will lead you to read what muscles control the size of the pupil. The action of dilating drop can be understood if you know the receptors on the muscles controlling the pupil.

Make sure that you read up on the cases seen after the clinic and discuss the cases with your colleagues. Try and learn to clerk the cases that you see in the clinic. Avoid the passive attitude and do not expect to be told or spoon-fed all the time. Be proactive and ask question.

Refrain from these situations in the clinic :

• Feel intimidated by the senior consultants.
• Become passive observers
• Reading books while lecturers are clerking patients
• Discuss among yourselves while lecturers are talking  to patients.

 (How to become a good & successful medical student; Muhaya Hj Mohamad)