If you have ever been admitted to a teaching hospital, you've probably encountered a medical student in your midst. You might wonder: Is this student actually here to help me, or am I a guinea pig here to help them learn? While the presence of budding doctors may make some patients uneasy, these students often grapple with their own anxieties about the transition out of the classroom and into the hospital room.
When I first started my clinical rotations, I felt apologetic about my presence in the hospital. Having spent the majority of the first two years of medical school in the classroom, I had limited real-life experience and seemingly little to contribute. I worried that I was an impediment to my clinical teams. Or worse, that my presence was a nuisance to patients. Then I met Jack and my view began to change.
Jack was a scrawny 3-year-old boy with a shaved head, huge smile and squishy cheeks. He was admitted to the hospital with worsening asthma. He arrived onto our hospital floor coughing and wheezing as his mom struggled to hold him still.
Our medical team — which consisted of three physicians and two students — determined during our evaluation that the child would need to receive albuterol, a drug used in asthma management, every few hours via an inhaler. As the student assigned to follow Jack, it was my job to examine him every one to two hours — more frequently than any of the physicians on my team — and report back on his status. Before I went home, I signed out to the overnight staff that he was breathing more comfortably.
The next morning, the overnight physicians reported that there had been some miscommunication between the physicians, respiratory therapists and nurses. Jack had not received several doses of his albuterol but had still slept through most of the night. One of the physicians had reevaluated Jack one hour before I arrived. He had been sleeping peacefully.
I jotted down these overnight events and went to see Jack. He was now wide awake, squirming in his bed and working hard to breathe.
The cardinal symptoms of an asthma attack were all there: his belly was heaving with each breath, the muscles around his ribs were straining to allow more air into his chest cavity and his nostrils were flaring.
I scurried back to our workroom and informed my team that Jack appeared to be worse. One of the physicians immediately went to examine him and decided to adjust his albuterol regimen.
To my surprise, the doctor thanked me for speaking up. I had recognized that Jack was in respiratory distress, and now he was being treated appropriately. I discovered that elusive feeling that every medical student desperately craves: to feel useful.
I know now that I can be useful by speaking up and asking questions. By doing so, I create learning opportunities for myself, making me a better clinician for my future patients. And occasionally, I might help my current patients.
Unfortunately, there's not a ton of research on whether medical students actually improve patient care. Although a 2015 review found that patient satisfaction was not "significantly affected by medical student participation," it also stated that attitudes varied widely and that the few existing studies may not be of sufficient quality to allow us to draw any conclusions.
I still believe we can help. Medical students have time to make extra trips to patients’ rooms, give them updates or listen to their detailed stories. Consequently, we can get to know patients better than others on the care team. We have the privilege of learning about their lives, wishes and fears. We then share this useful information with our teams so that we may offer better, more personalized care.
Over the next 24 hours, Jack’s breathing improved significantly. By the following morning, he was running around the room without wheezing and ready for discharge. On his way out, Jack waved me down.
“Thank you!” he shouted and ran away, his mother chasing after him. I smiled, with a burst of satisfaction inside.
Of course, not all patients are as happy-go-lucky as Jack. Being a patient in a hospital is a scary and disorienting experience. When strangers invade your space to poke and prod, it can be easy to feel as though you are the subject of a lab experiment. You may wonder if these people have your best interests in mind. Perhaps having additional people involved in your care feels unnecessary and diminishes your sense of privacy.
But I believe that medical students are good for your health. We keep an eye on you and report back to our teams. We advocate for you and wish to facilitate your healing. Having only recently donned our white coats, we might more easily see things from your perspective. And in a few years, we will be the doctors taking care of you. By trusting us, you help us become the skilled, knowledgeable and compassionate doctors that every patient deserves.
Andi Shahu is a medical student at the Yale School of Medicine.